MEDICARE: MR. GILBERT RICHARD NELMES P.A,-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	PA30106DC	DC

General Provider Information

NPI Number	:	1700977394
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. GILBERT RICHARD NELMES P.A,-C

Provider Business Mailing Address
First Line	:	802 WALNUT AVE
Second Line	:
City	:	NORTH BEACH
State	:	MD
Zip	:	20714-9615
Country	:	US
Telephone Number	:	301-461-3942
Fax Number	:

Provider Business Practice Location Address
First Line	:	600 PENNSYLVANIA AVE SE STE 202
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20003-4344
Country	:	US
Telephone Number	:	202-544-5858
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/27/2006
Last Update Date	:	07/31/2012

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