Individual
MICHAEL SCOTT KENLY
Active
Individual
MICHAEL SCOTT KENLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
62730
GA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
A113590
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A113590
DCA MEDICAL LICENSE
CA
01
—
EJ158Y
NORTHERN MEDICARE PTAN
CA
01
—
EJ158Z
SOUTHERN MEDICARE PTAN
CA
Enumeration date
12/29/2007
Last updated
08/19/2015
Update your record
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