Individual
DR. BRUCE KELLNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
10101 COLESVILLE RD, SILVER SPRING, MD 20901-2426
(301) 754-0101
(301) 754-0103
Mailing address
10101 COLESVILLE RD, SILVER SPRING, MD 20901-2426
(301) 754-0101
(301) 754-0103
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
DA0637
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
077887600
—
DC
05
—
088206200
—
MD
01
—
1992121669
GROUP NPI
MD
Enumeration date
12/08/2006
Last updated
01/17/2017
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