Individual
THOMAS KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
201 NTH MAYFAIR RD, 2ND FLOOR, WAUWATOSA, WI 53226
(414) 771-8228
(414) 256-2483
Mailing address
201 NTH MAYFAIR RD, 2ND FLOOR, WAUWATOSA, WI 53226
(414) 771-8228
(414) 256-2483
Taxonomy
Speciality
Code
Description
License number
State
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
31137
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31597200
—
WI
Enumeration date
08/28/2006
Last updated
09/22/2008
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