Individual
SEAN KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD14937
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
041366
ANTHEM BLUE CROSS
ME
01
—
050092018
RAILROAD MEDICARE
ME
05
—
195860099
—
ME
Enumeration date
10/17/2006
Last updated
06/29/2017
Update your record
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