Individual
KELLY D VENABLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2401 W BELVEDERE AVE, CREDENTILAING, BALTIMORE, MD 21215-5216
(410) 601-6340
Mailing address
2401 W BELVEDERE AVE, CREDENTILAING, BALTIMORE, MD 21215-5216
(410) 601-6340
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
C0002274
MD
Other
Enumeration date
04/15/2010
Last updated
07/28/2010
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