Individual
MR. MICHAEL THOMAS KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
NP
Contact information
Practice address
99 TAVERN RD, MARTINSBURG, WV 25401-2890
(304) 263-4999
(304) 263-0984
Mailing address
PO BOX 1146, MARTINSBURG, WV 25402-1146
(304) 263-4999
Taxonomy
Speciality
Code
Description
License number
State
163WA2000X
Administrator Registered Nurse
170876
MA
363LF0000X
Family Nurse Practitioner
Primary
103811
WV
Other
Enumeration date
09/12/2006
Last updated
07/17/2019
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