Individual
KELLY J KIEHM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3600 OLENTANGY RIVER RD, BLDG 480, COLUMBUS, OH 43214-3437
(614) 300-1105
(614) 678-8851
Mailing address
3600 OLENTANGY RIVER RD, STE 480, COLUMBUS, OH 43214-3485
(614) 442-0700
(614) 678-8851
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
35080525
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000483231
ANTHEM PIN
OH
05
—
2647112
—
OH
01
—
4982480003
DMEPOS
OH
Enumeration date
10/24/2005
Last updated
02/19/2020
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