Individual
DAVID LEE KELLY JR.
Active
Individual
DAVID LEE KELLY JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
11526
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
204068000
—
WV
01
—
26310
MEDCOST
NC
01
—
2875
PARTNERS
NC
01
—
4382149
AETNA
NC
01
—
48205
BCBS
NC
05
—
6133801
—
VA
05
—
8948205
—
NC
05
—
Q11526
—
SC
Enumeration date
01/13/2006
Last updated
08/20/2010
Update your record
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