Kelly, Michael W

Kelly, Michael W is an individual health care provider with primary practice located at 5100 Gamble Dr Suite 100 - Mail Stop 31200A Healthpartners West Clinic, St. Louis Park MN 55416-1582. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kelly, Michael W can be contacted via phone (952) 541-2500.

Contact Information

Primary practice address
5100 Gamble Dr Suite 100 - Mail Stop 31200A Healthpartners West Clinic St. Louis Park MN 55416-1582
Phone: (952) 541-2500
Fax: (952) 595-6455
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 26970 Minnesota

Profile Details

NPI number 1598738197
LBN Legal business name Kelly, Michael W
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2006
Last updated Dec 12th, 2011 - about 13 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 1598738197 NPPES
Minnesota MEDICAID 400582100

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