Individual
MICHAEL PAUL KELLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4708 ALLIANCE BLVD STE 550, PLANO, TX 75093-5363
(972) 758-6000
(972) 758-6001
Mailing address
4708 ALLIANCE BLVD STE 550, PLANO, TX 75093-5363
(972) 758-6000
(972) 758-6001
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
L7445
TX
2084S0012X
Sleep Medicine (Psychiatry & Neurology) Physician
Primary
L7445
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1649154-01
—
TX
01
—
8F4614
BCBS
TX
Enumeration date
08/20/2006
Last updated
02/06/2023
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