Individual
MICHAEL MARTIN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
550 S GODDARD BLVD, KING OF PRUSSIA, PA 19406-2922
(445) 428-3000
Mailing address
1125 LINDALE AVE, DREXEL HILL, PA 19026-3221
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
SP025663
PA
Other
Enumeration date
05/05/2022
Last updated
05/05/2022
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