Organization
KISHAN L KELLA MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KISHAN L KELLA MD PC (OWNER)
(989) 752-6116
Entity
Organization
Contact information
Practice address
625 N MICHIGAN AVE, SAGINAW, MI 48602-4340
(989) 752-6116
(989) 752-0074
Mailing address
625 N MICHIGAN AVE, SAGINAW, MI 48602-4340
(989) 752-6116
(989) 752-0074
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
KK046739
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4600834
—
MI
05
—
4723665
—
MI
Enumeration date
05/26/2006
Last updated
05/27/2009
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