Provider Demographics
NPI:1578829354
Name:ANNAPOLIS ALLERGY & ASTHMA LLC
Entity Type:Organization
Organization Name:ANNAPOLIS ALLERGY & ASTHMA LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN AND OWNER
Authorized Official - Prefix:
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:M
Authorized Official - Last Name:GELS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-573-1600
Mailing Address - Street 1:PO BOX 7801
Mailing Address - Street 2:
Mailing Address - City:BELFAST
Mailing Address - State:ME
Mailing Address - Zip Code:04915-7800
Mailing Address - Country:US
Mailing Address - Phone:410-573-1600
Mailing Address - Fax:410-573-5841
Practice Address - Street 1:4175 N HANSON CT
Practice Address - Street 2:SUITE 201
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3179
Practice Address - Country:US
Practice Address - Phone:410-573-1600
Practice Address - Fax:410-573-5841
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-06
Last Update Date:2012-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD40281207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
238562Medicare PIN