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Individual
MARK A. KELLEY
Active
Individual
MARK A. KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
076453
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
076453
MI
207RP1001X
Pulmonary Disease Physician
Primary
076453
MI
Other
Enumeration date
12/01/2006
Last updated
05/06/2019
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