Individual
RAYMOND KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
323 LOWELL ST, ANDOVER, MA 01810
(978) 783-5000
(978) 313-8184
Mailing address
323 LOWELL ST, ANDOVER, MA 01810-4501
(978) 783-5000
(978) 313-8184
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
275150
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000042886
BMC HEALTHNET PLAN
—
01
—
0107100Y0NH02
ANTHEM
NH
05
—
0118842
—
MA
05
—
271040099
—
ME
05
—
30008650
—
NH
01
—
3428550
CIGNA
—
01
—
930055342
RAILROAD MEDICARE
—
01
—
AA86677
HARVARD PILGRIM
—
01
—
P00457777
RAILROAD MEDICARE
NH
Enumeration date
08/08/2006
Last updated
09/26/2018
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