Kelly, Charles Michael

Kelly, Charles Michael is an individual health care provider with primary practice located at 7710 Mercy Rd Suite 224, Omaha NE 68124-2372. He recently has only one registered license in Allopathic & Osteopathic Physicians / Orthopaedic Surgery, which is considered as his primary health care specialty. Kelly, Charles Michael can be contacted via phone (402) 399-8550.

Contact Information

Primary practice address
7710 Mercy Rd Suite 224 Omaha NE 68124-2372
Phone: (402) 399-8550
Fax: (402) 399-8455
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X 16976 Nebraska

Profile Details

NPI number 1528009800
LBN Legal business name Kelly, Charles Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 9th, 2006
Last updated Apr 18th, 2019 - about 7 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 1528009800 NPPES
Nebraska Other 03880 BCBS OF NEBRASKA
Nebraska Other 09-00180 BCBS OF NEBRASKA
Nebraska MEDICAID 0989095 BCBS OF NEBRASKA
Nebraska MEDICAID 47063010113 BCBS OF NEBRASKA
Nebraska Other 16404 BCBS OF NEBRASKA
Nebraska Other 09-01137 BCBS OF NEBRASKA

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