Individual
DR. KEVIN J KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9000 W WISCONSIN AVE, PEDIATRIC ALLERGY/IMMUNOLOGY, MILWAUKEE, WI 53226-4874
(414) 607-5280
(414) 266-6849
Mailing address
9000 W WISCONSIN AVE, PEDIATRIC ALLERGY/IMMUNOLOGY, MILWAUKEE, WI 53226-4874
(414) 607-5280
(414) 266-6849
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
2005026718
MO
2080P0201X
Pediatric Allergy/Immunology Physician
Primary
22420
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1396703450
—
WI
05
—
207550708
—
MO
Enumeration date
05/01/2006
Last updated
12/08/2011
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