Healthcare Provider Details

I. General information

NPI: 1306003652
Provider Name (Legal Business Name): GEMMA MELANIE ARMSTRONG D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GEMMA M ARIAS D.O.

II. Dates (important events)

Enumeration Date: 05/22/2008
Last Update Date: 12/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

253 LEWIS LN SUITE 202
HAVRE DE GRACE MD
21078-3750
US

IV. Provider business mailing address

PO BOX 99
CONOWINGO MD
21918-0099
US

V. Phone/Fax

Practice location:
  • Phone: 443-502-7060
  • Fax: 410-378-9922
Mailing address:
  • Phone: 410-378-9696
  • Fax: 410-378-0787

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberH77365
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: