Individual
KELLY L MCCLEAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
7300 DEXTER-ANN ARBOR RD, SUITE 110, DEXTER, MI 48130-8598
(734) 426-2796
Mailing address
3621 S STATE ST, 700 KMS PLACE, ANN ARBOR, MI 48108
(734) 936-2047
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
4301073167
MI
208000000X
Pediatrics Physician
4301073167
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3502982
—
MI
Enumeration date
10/17/2006
Last updated
02/05/2015
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