Kelly, Peter H

Kelly, Peter H is an individual health care provider with primary practice located at 310 Smith Ave N , Saint Paul MN 55102-2393. He recently has 2 registered licenses in different health care specialties including Other Service Providers / Specialist, Allopathic & Osteopathic Physicians / Surgery. Allopathic & Osteopathic Physicians / Surgery is his primary health care specialty. Kelly, Peter H can be contacted via phone (952) 843-4333.

Contact Information

Primary practice address
310 Smith Ave N Saint Paul MN 55102-2393
Phone: (952) 843-4333
Fax: (952) 843-4301
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Specialist 174400000X 29590 Minnesota
Allopathic & Osteopathic Physicians / Surgery 208600000X 29590 Minnesota

Profile Details

NPI number 1669447850
LBN Legal business name Kelly, Peter H
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 21st, 2006
Last updated Nov 23rd, 2020 - about 4 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 1669447850 NPPES
Minnesota MEDICAID 392777600

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