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Individual
CHARLES E KELLY II
Active
Individual
CHARLES E KELLY II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
40151
TN
207RG0100X
Gastroenterology Physician
Primary
40151
TN
Other
Enumeration date
09/02/2005
Last updated
03/13/2009
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