Kelly, Steven Michael

Kelly, Steven Michael is an individual health care provider with primary practice located at 1551 Renaissance Towne Dr Suite 310, Bountiful UT 84010-7667. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatric Otolaryngology, which is considered as his primary health care specialty. Kelly, Steven Michael can be contacted via phone (801) 295-5581.

Contact Information

Primary practice address
1551 Renaissance Towne Dr Suite 310 Bountiful UT 84010-7667
Phone: (801) 295-5581
Fax: (801) 295-9253
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatric Otolaryngology 207YP0228X 182660-1205 Utah

Profile Details

NPI number 1841348240
LBN Legal business name Kelly, Steven Michael
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 8th, 2007
Last updated Nov 3rd, 2021 - about 3 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 1841348240 NPPES
Wyoming MEDICAID 110583300
Wyoming MEDICAID 003084400

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