Kelly, Michael

Kelly, Michael is an individual health care provider with primary practice located at 7733 E Jefferson Ave , Detroit MI 48214-3707. He recently has only one registered license in Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology, which is considered as his primary health care specialty. Kelly, Michael can be contacted via phone (313) 499-3000.

Contact Information

Primary practice address
7733 E Jefferson Ave Detroit MI 48214-3707
Phone: (313) 499-3000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Anatomic Pathology & Clinical Pathology 207ZP0102X 4301065795 Michigan

Profile Details

NPI number 1912981010
LBN Legal business name Kelly, Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 1st, 2005
Last updated Oct 31st, 2013 - about 11 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 1912981010 NPPES
Michigan Other BLUE CROSS 340H275000
Michigan Other COMMERICAL 340H275000

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