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Individual
JOHN J KELEMEN III
Active
Individual
JOHN J KELEMEN III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
Primary
01075452A
IN
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
04-31210
KS
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
34064
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000001006309
ANTHEM PROVIDER NUMBER
IN
05
—
200326510A
—
KS
05
—
200326510D
—
KS
05
—
201291370
—
IN
Enumeration date
03/28/2006
Last updated
02/25/2019
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