Dr Charles E Kelly, MD is a
Specialist physician based in Roseville, Minnesota. Dr Charles E Kelly is licensed to practice in Minnesota (license number 26263) and his current practice location is 3050 Centre Pointe Drive, Suite 200, Roseville, Minnesota. He can be reached at his office (for appointments etc.) via phone at
(651) 631-4242.
NPI number for Dr Charles E Kelly is 1730123639 and his current mailing address is 3050 Centre Pointe Drive, Suite 200, Roseville, Minnesota. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1730123639.
Physician's Profile
| Full Name | Dr Charles E Kelly |
|---|
| Gender | Male |
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| Speciality | Specialist |
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| Location | 3050 Centre Pointe Drive, Roseville, Minnesota |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1730123639
- Provider Enumeration Date: 06/15/2006
- Last Update Date: 02/11/2016
Medical Identifiers
Medical identifiers for Dr Charles E Kelly such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1730123639 | NPI | - | NPPES |
| 286577 | Medicaid | MN | |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 207R00000X | Internal Medicine | 26263 (Minnesota) | Secondary |
| 174400000X | Specialist | 26263 (Minnesota) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Charles E Kelly is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Charles E Kelly, MD
3050 Centre Pointe Drive, Suite 200,
Roseville, MN 55113
Ph: (651) 639-9150 | Dr Charles E Kelly, MD
3050 Centre Pointe Drive, Suite 200,
Roseville, MN 55113
Ph: (651) 631-4242 |
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