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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1669447850 | NPPES |
| Minnesota | MEDICAID | 392777600 |
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