Kellam, D Michael

Kellam, D Michael is an individual health care provider with primary practice located at 800 E 20Th St Suite 110, Cheyenne WY 82001-3859. He recently has only one registered license in Allopathic & Osteopathic Physicians / Diagnostic Radiology, which is considered as his primary health care specialty. Kellam, D Michael can be contacted via phone (307) 634-7711.

Contact Information

Primary practice address
800 E 20Th St Suite 110 Cheyenne WY 82001-3859
Phone: (307) 634-7711
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 4219A Wyoming
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 26458 Colorado
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 21264 Nebraska

Profile Details

NPI number 1982648937
LBN Legal business name Kellam, D Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 16th, 2006
Last updated Jul 9th, 2007 - about 18 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 1982648937 NPPES
Wyoming Other 306010 BCBS OF WYOMING CRG
Wyoming MEDICAID 91042192 BCBS OF WYOMING CRG
Wyoming MEDICAID 104015400 BCBS OF WYOMING CRG
Wyoming Other 303602 BCBS OF WYOMING CRG

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