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General NPI Number Information
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NPI Number | 1699944264
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Entity Type | Individual
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Provider Name | PHILIP BENJAMIN BOVELL MD
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Gender | Male
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Dates
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Enumeration Date | 02/27/2008
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Last Update Date | 05/15/2009
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Provider Practice Location Address
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Address Line | 11701 LIVINGSTON ROAD STE 204
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City | FORT WASHINGTON
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State | MD
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Zip | 20744-5104
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Country | US
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Telephone | 301-292-0757
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Fax |
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Provider Business Mailing Address
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Address Line | 11701 LIVINGSTON ROAD STE 204
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City | FORT WASHINGTON
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State | MD
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Zip | 20744-5104
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Country | US
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Telephone | 301-292-0757
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | D0020121
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License Number State | MD
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