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Individual
MOLLY A KELLY
Active
Individual
MOLLY A KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
01081728A
IN
207Q00000X
Family Medicine Physician
01081728A
IN
208M00000X
Hospitalist Physician
Primary
01081728A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001338628
ANTHEM PTAN
IN
01
—
000001338637
ANTHEM PTAN
IN
01
—
000001525751
ANTHEM PTAN
IN
05
—
300007459
—
IN
Enumeration date
06/01/2017
Last updated
01/09/2025
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