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Individual
PAUL D KELTY
Active
Individual
PAUL D KELTY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
01029084A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000042440
ANTHEM
IN
05
—
100128130A
—
IN
01
—
1111620
PASSPORT HEALTH PLANS
KY
05
—
64755101
—
KY
Enumeration date
09/22/2006
Last updated
08/31/2012
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