Individual
MICHAELA J CLARK-KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
15 ENTERPRISE DR, AUGUSTA, ME 04330-7997
(207) 621-8800
(207) 621-8801
Mailing address
15 ENTERPRISE DR, AUGUSTA, ME 04330-7997
(207) 621-8800
(207) 621-8801
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1802
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
431974999
—
ME
Enumeration date
11/04/2005
Last updated
08/12/2025
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