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Individual
DANIEL P KELLAR
Active
Individual
DANIEL P KELLAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01041390
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080045458
RR MEDICARE
IN
05
—
100253010
—
IN
Enumeration date
11/02/2005
Last updated
10/18/2010
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