Individual
CARMEL M KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1093 N MAIN ST, RANDOLPH, MA 02368-2100
(781) 963-0676
(781) 963-7417
Mailing address
1093 N MAIN ST, RANDOLPH, MA 02368-2100
(781) 963-0676
(781) 963-7417
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
57521
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0100052
EVERCARE
—
01
—
0100918
UNITED HLTHCARE OF NE
NE
01
—
043243146
UNICARE
—
01
—
21003084366
BEECH STREET
—
05
—
3022447
—
MA
01
—
3567516
AETNA HEALTH PLAN
—
01
—
64506
HARVARD PILGRIM
—
01
—
7134757002
CIGNA
—
01
—
J06362
BLUE CARE ELECT
—
01
—
M15986
BLUE CROSS INDEMNITY
—
Enumeration date
09/06/2005
Last updated
04/07/2011
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