Kelley, Michael John
Kelley, Michael John is an individual health care provider with primary practice located at 1906 Belleview Ave Se , Roanoke VA 24014-1838. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Kelley, Michael John can be contacted via phone (540) 981-7083.Contact Information
Primary practice address
1906 Belleview Ave Se
Roanoke VA 24014-1838
Phone: (540) 981-7083
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 31847 | North Carolina |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 20717 | South Carolina |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | C38560 | California |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 20717 | South Carolina |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | C38560 | California |
| Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology | 2085R0204X | 31847 | North Carolina |
| Allopathic & Osteopathic Physicians / Diagnostic Radiology | 2085R0202X | 0101274514 | Virginia |
Profile Details
| NPI number | 1700883154 |
|---|---|
| LBN Legal business name | Kelley, Michael John |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 30th, 2005 |
| Last updated | Jan 9th, 2023 - about last year |
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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700883154 | NPPES |
| North Carolina | Other | NC 300096436 | RR MEDICARE NC |
| North Carolina | MEDICAID | 8948125 | RR MEDICARE NC |
| North Carolina | MEDICAID | N31847 | RR MEDICARE NC |
| North Carolina | Other | SC 300109599 | RR MEDICARE NC |
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