Individual
BRIAN G KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
25959 KELLY ROAD, SUITE B, ROSEVILLE, MI 48066
(586) 773-9510
(586) 773-6888
Mailing address
25959 KELLY ROAD, SUITE B, ROSEVILLE, MI 48066
(586) 773-9510
(586) 773-6888
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
4301044066
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2884854
—
MI
Enumeration date
08/31/2006
Last updated
07/08/2007
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