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Individual
PAUL DENNIS KELLEHER
Active
Individual
PAUL DENNIS KELLEHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
50-00-0492
OH
363AS0400X
Surgical Physician Assistant
Primary
50-00-0492
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000015457-00
WORKERS COMPENSATION
OH
Enumeration date
08/03/2006
Last updated
09/14/2018
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