| Kevin J. Kelly Md, Pc | |
|
8145 Valleywood Ln Ste B Portage MI 49024-5296 | |
| (269) 324-9162 | |
| (269) 375-6079 |
| Full Name | Kevin J. Kelly Md, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 8145 Valleywood Ln Ste B, Portage, Michigan |
| Authorized Official Name and Position | Kevin J Kelly (OWNER) |
| Authorized Official Contact | 2693249162 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin J. Kelly Md, Pc 8145 Valleywood Ln Ste B Portage MI 49024-5296 Ph: (269) 324-9162 | Kevin J. Kelly Md, Pc 8145 Valleywood Ln Ste B Portage MI 49024-5296 Ph: (269) 324-9162 |
| NPI Number | 1689868697 |
|---|---|
| Provider Enumeration Date | 09/02/2007 |
| Last Update Date | 09/02/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689868697 | NPI | - | NPPES |
| 0390022 | Other | MI | BCBSM |
| 4282408 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 039833 (Michigan) | Primary |
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