Individual
MICHAEL E KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
100 CAMPUS AVE, SUITE 208, LEWISTON, ME 04240-6040
(207) 777-8974
(207) 777-8946
Mailing address
PO BOX 10187, ALBANY, NY 12201-5187
(207) 777-4111
(207) 783-6660
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
014859
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
339290099
—
ME
Enumeration date
07/06/2006
Last updated
07/22/2011
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