# KELLAM & ASSOCIATES

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1811151202
- **Authorized official:** LEIGHTON LUM D.O. (PARTNER)
- **Authorized official phone:** (734) 677-7400

## Contact information

- **Practice address:** 399 S BROADWAY ST, LAKE ORION, MI 48362-2740
- **Practice address phone:** (248) 338-5604
- **Practice address fax:** (248) 338-5605
- **Mailing address:** 4420 VARSITY DR, ANN ARBOR, MI 48108-2233
- **Mailing address phone:** (734) 677-7400
- **Mailing address fax:** (734) 677-7407

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 2085R0202X | Diagnostic Radiology Physician | — | NULL | — |
| 2085R0202X | Diagnostic Radiology Physician | — | — | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | NULL | — |
| 2085R0204X | Vascular & Interventional Radiology Physician | — | — | — |
| 208VP0000X | Pain Medicine Physician | — | NULL | Yes |
| 208VP0000X | Pain Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/15/2008
- **Last updated:** 12/14/2009