Individual
DAVID L. KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8220 MEADOWBRIDGE RD, SUITE 203, MECHANICSVILLE, VA 23116-2336
(804) 764-1253
(804) 764-1259
Mailing address
8220 MEADOWBRIDGE RD, SUITE 203, MECHANICSVILLE, VA 23116-2336
(804) 764-1253
(804) 764-1259
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101037821
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005847851
—
VA
01
—
110170382
RAILROAD MEDICARE
VA
01
—
1383250
CIGNA
VA
01
—
296096
MAMSI
VA
01
—
432880
ANTHEM BCBS OF VA
VA
01
—
4458500
AETNA HMO
VA
01
—
45906
SENTARA
VA
01
—
79153
SOUTHERN HEALTH SERVICES
VA
Enumeration date
06/29/2006
Last updated
11/24/2009
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