Clark-Kelley, Michaela J

Clark-Kelley, Michaela J is an individual health care provider with primary practice located at 180 Kennedy Memorial Dr Suite 301, Waterville ME 04901-4540. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Clark-Kelley, Michaela J can be contacted via phone (207) 873-3753.

Contact Information

Primary practice address
180 Kennedy Memorial Dr Suite 301 Waterville ME 04901-4540
Phone: (207) 873-3753
Fax: (207) 873-2620
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 1802 Maine

Profile Details

NPI number 1306837620
LBN Legal business name Clark-Kelley, Michaela J
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 4th, 2005
Last updated Apr 10th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1306837620 NPPES
Maine MEDICAID 431974999

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