Individual
DR. MAUREEN A KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
43205 WOODWARD AVE, BLOOMFIELD HILLS, MI 48302-5006
(248) 451-0600
(248) 451-0700
Mailing address
PO BOX 44047, DETROIT, MI 48244-0047
(248) 451-0600
(248) 451-0700
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301056543
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4183802
—
MI
Enumeration date
07/11/2005
Last updated
04/29/2009
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