Individual
DR. VIPUL KELLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2333 BIDDLE ST, WYANDOTTE, MI 48192-4668
(313) 284-9400
Mailing address
160 TIFFANY LN, ROYAL OAK, MI 48067-3271
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
35C.001199
OH
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
Primary
079624
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104769889
—
MI
05
—
104842192
—
MI
01
—
VK079624
BLUE SHIELD
MI
Enumeration date
07/06/2006
Last updated
02/08/2024
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