| Kelly Collaborative Medicine | |
|
10801 Lockwood Dr Suite 210 Silver Spring MD 20901-1556 | |
| (301) 298-1040 | |
| (844) 288-6896 |
| Full Name | Kelly Collaborative Medicine |
|---|---|
| Speciality | Internal Medicine |
| Location | 10801 Lockwood Dr, Silver Spring, Maryland |
| Authorized Official Name and Position | Kathryn Delores Garrett Kelly (OWNER) |
| Authorized Official Contact | 2025499557 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Collaborative Medicine 10801 Lockwood Dr Suite 210 Silver Spring MD 20901-1556 Ph: (301) 298-1040 | Kelly Collaborative Medicine 10801 Lockwood Dr Suite 210 Silver Spring MD 20901-1556 Ph: (301) 298-1040 |
| NPI Number | 1639521966 |
|---|---|
| Provider Enumeration Date | 07/11/2016 |
| Last Update Date | 08/24/2016 |
| Medicare PECOS PAC ID | 9931496833 |
|---|---|
| Medicare Enrollment ID | O20160920003036 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639521966 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | D0076087 (Maryland) | Primary |
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Secondary |
| Provider Name | Kathryn D Kelly |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1649447228 PECOS PAC ID: 4587858980 Enrollment ID: I20101029000890 |
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