Individual
EDWARD A. KELLY JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
99 MANOR AVE, DOWNINGTOWN, PA 19335-2620
(610) 269-2377
(610) 269-5022
Mailing address
99 MANOR AVE, DOWNINGTOWN, PA 19335-2620
(610) 269-2377
(610) 269-5022
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD017677E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0008960230004
—
PA
01
—
2234277001
IBC ID
PA
01
—
233069058
TAX ID
PA
01
—
MD017677E
LICENSE
PW
Enumeration date
08/24/2005
Last updated
03/07/2023
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