Organization
JOHN EDWARD KELLY MD PA
Active
Other names
JOHN EDWARD KELLY MD PA
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN EDWARD KELLY MD (PRESIDENT)
(301) 212-9200
Entity
Organization
Contact information
Practice address
2401 RESEARCH BLVD STE 340, ROCKVILLE, MD 20850-6254
(301) 212-9200
Mailing address
2401 RESEARCH BLVD STE 340, ROCKVILLE, MD 20850-6254
(301) 212-9200
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0006349
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
113251200
—
MD
Enumeration date
11/17/2010
Last updated
12/15/2010
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