Individual
MATTHEW DAVID KELLEMS
Active
Individual
MATTHEW DAVID KELLEMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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