Individual
MICHAEL PAUL KELLAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
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
Update your record
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