Kelley, Laurence R

Kelley, Laurence R is an individual health care provider with primary practice located at 15215 Shady Grove Rd Suite 306, Rockville MD 20850-3235. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Kelley, Laurence R can be contacted via phone (301) 990-0040.

Contact Information

Primary practice address
15215 Shady Grove Rd Suite 306 Rockville MD 20850-3235
Phone: (301) 990-0040
Fax: (301) 990-0043
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X D0047655 Maryland

Profile Details

NPI number 1083676498
LBN Legal business name Kelley, Laurence R
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 3rd, 2006
Last updated Oct 16th, 2007 - about 17 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 1083676498 NPPES
Maryland Other 53607302 BCBS OF MD INDIVIDUAL #
Maryland Other 4787 BCBS OF MD INDIVIDUAL #
Maryland Other H830 BCBS OF MD INDIVIDUAL #
Maryland Other 0009 BCBS OF MD INDIVIDUAL #

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