Individual
DR. MICHAEL PARRIS KELLETT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
890 W FARIS RD, SUITE 330, GREENVILLE, SC 29605-4247
(864) 233-1112
Mailing address
255 ENTERPRISE BLVD, SUITE 102, GREENVILLE, SC 29615-6300
(864) 454-2143
(864) 454-1144
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
6112
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
061122
—
SC
01
—
1575427
CIGNA
SC
01
—
4651521
AETNA
SC
01
—
57-1004971032
BCBS OF SC
SC
Enumeration date
07/05/2006
Last updated
07/09/2007
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