Individual
RUSSELL KELLEY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FOGG RD, SOUTH WEYMOUTH, MA 02190-2432
(781) 337-7011
Mailing address
PO BOX 1079, LEWISTON, ME 04243-1079
(800) 456-1552
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
54233
MA
Other
Enumeration date
01/08/2006
Last updated
07/08/2007
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