Individual
THOMAS KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
850 W BARAGA AVE STE 32, MARQUETTE, MI 49855-4550
(906) 449-3680
Mailing address
1025 MOREHEAD MEDICAL DR, CHARLOTTE, NC 28204-2963
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
4301500343
MI
Other
Enumeration date
08/19/2010
Last updated
01/13/2020
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