Individual
DR. MICHAEL THOMAS KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4156 H STREET RD, BLAINE, WA 98230-9228
(360) 332-1474
Mailing address
4156 H STREET RD, BLAINE, WA 98230-9228
(360) 332-1474
Taxonomy
Speciality
Code
Description
License number
State
207ZM0300X
Medical Microbiology Physician
Primary
MD 00039400
WA
Other
Enumeration date
09/12/2011
Last updated
09/12/2011
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