Miller, Kelly L

Miller, Kelly L is an individual health care provider with primary practice located at 1417 Madison Park Drive , Glen Burnie MD 21061. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is her primary health care specialty. Miller, Kelly L can be contacted via phone (410) 768-6600.

Contact Information

Primary practice address
1417 Madison Park Drive Glen Burnie MD 21061
Phone: (410) 768-6600
Fax: (410) 553-0710
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X D61418 Maryland
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X D61418 Maryland

Profile Details

NPI number 1205897287
LBN Legal business name Miller, Kelly L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 30th, 2006
Last updated Mar 19th, 2012 - about 12 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 1205897287 NPPES
Maryland MEDICAID 004362100
Maryland Other P00434480

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