Individual
DOUGLAS JOHN KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
8380 CADILLAC CIR, GROSSE ILE, MI 48138-2257
(734) 818-7673
Mailing address
8380 CADILLAC CIR, GROSSE ILE, MI 48138-2257
(734) 818-7673
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5101020104
MI
390200000X
Student in an Organized Health Care Education/Training Program
5101020104
MI
Other
Enumeration date
06/14/2012
Last updated
03/18/2025
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