Individual
KELLI LYNNE VIRGIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
11855 E 12 MILE RD STE 400, WARREN, MI 48093-3471
(586) 586-6630
(586) 582-6631
Mailing address
500 OSBORN BLVD, SAULT SAINTE MARIE, MI 49783-1822
(906) 253-0113
(586) 582-6631
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
5101020536
MI
207RE0101X
Endocrinology, Diabetes & Metabolism Physician
Primary
5101020536
MI
Other
Enumeration date
05/16/2013
Last updated
10/03/2019
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