Individual
DR. TERESA GROSS KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Taxonomy
Speciality
Code
Description
License number
State
2085P0229X
Pediatric Radiology Physician
52993
WI
2085P0229X
Pediatric Radiology Physician
ME70684
FL
2085R0202X
Diagnostic Radiology Physician
Primary
4301052060
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1275580672
—
WI
05
—
250150300
—
FL
Enumeration date
05/30/2006
Last updated
11/26/2024
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