Individual provider · Type 1 NPI

Gary Ross Fennel, PA-C

Surgical Physician Assistant · Takoma Park, MD

NPI number 1295889418 Active

Practice location

7600 Carroll Ave, Washington Adventist Hospital
Takoma Park, MD 20912-6367

Fax (301) 891-6313

Mailing address

15714 Thistlebridge Dr
Rockville, MD 20853-3226

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400XC0000622 (MD)

Surgical Physician Assistant: Definition to come...

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About NPI 1295889418

Gary Ross Fennel, PA-C's National Provider Identifier is 1295889418, issued on Jan 23, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Takoma Park, MD. The record was last updated on Jul 8, 2007.