Provider Demographics
NPI:1750657268
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:DR
Authorized Official - First Name:DUANE
Authorized Official - Middle Name:
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 1:129 LUBRANO DR
Practice Address - Street 2:SUITE 200
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-7564
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:2012-03-29
Last Update Date:2015-11-30
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
240727Medicare PIN