Individual
KELLEY MAHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
110 W HEWITT AVE, MARQUETTE, MI 49855-3533
(906) 360-2636
Mailing address
110 W HEWITT AVE, MARQUETTE, MI 49855-3533
(906) 360-2636
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
4301073735
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104430369
—
MI
Enumeration date
07/07/2006
Last updated
04/18/2019
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