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Individual

EDWARD KELMENSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1700 S 23RD ST, FORT PIERCE, FL 34950-4803
(772) 461-4000
(866) 665-2702
Mailing address
36 HARBOUR ISLE DR W, #202, HUTCHINSON ISLAND, FL 34949-2788
(207) 478-5944
(866) 665-2702

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
MD423579
PA
207L00000X
Anesthesiology Physician
Primary
ME114394
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1654066
HIGHMARK BLUE SHIELD
PA
01
50041807
KEYSTONE HEALTH PLAN CENT
PA
01
90174
GEISINGER HEALTH PLAN
PA
Enumeration date
07/12/2006
Last updated
06/17/2013
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