Individual
DAVID KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
275 SANDWICH ST, PLYMOUTH, MA 02360-2183
(508) 830-2121
Mailing address
PO BOX 1260, ATT: DENISE COSTA, PLYMOUTH, MA 02362-1260
(774) 454-8868
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
224721
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2104253
—
MA
Enumeration date
09/08/2005
Last updated
09/22/2010
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