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NPI Code Detail

MEDICARE: DR. ALLISON MICHAEL PHELPS M.D.

MEDICARE:  DR. ALLISON MICHAEL PHELPS  M.D.
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
1207QS0010XSports Medicine (Family Medicine) PhysicianR9269TX

General Provider Information

NPI Number : 1487816914
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ALLISON MICHAEL PHELPS M.D.
Provider Business Mailing Address
First Line : 1317 ROUTE 73 STE 200
Second Line :
City : MOUNT LAUREL
State : NJ
Zip : 08054-2202
Country : US
Telephone Number : 856-439-6111
Fax Number :
Provider Business Practice Location Address
First Line : 5122 GLENCROSSING WAY
Second Line :
City : CINCINNATI
State : OH
Zip : 45238-3361
Country : US
Telephone Number : 513-827-9044
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/26/2008
Last Update Date : 10/24/2023

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Directions to “ DR. ALLISON MICHAEL PHELPS M.D.” Practice Location

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