Individual
MATTHEW DAVID KELLEMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11100 EUCLID AVE, CLEVELAND, OH 44106
(216) 844-7330
Mailing address
24701 EUCLID AVE, 3RD FLOOR, EUCLID, OH 44117-1714
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35091034
OH
207L00000X
Anesthesiology Physician
57.008961
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0055847
—
OH
05
—
2853489
—
OH
01
—
P00662779
MEDICARE RAILROAD
OH
Enumeration date
05/25/2007
Last updated
04/24/2012
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