Individual
MICHAEL W. KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
200 PATEWOOD DR, SUITE B200, GREENVILLE, SC 29615-3593
(864) 232-7338
(864) 239-6645
Mailing address
P. O. BOX 8676, GREENVILLE, SC 29604-8676
(864) 232-7338
(864) 239-6645
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
7061
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
070611
—
SC
Enumeration date
10/02/2006
Last updated
05/23/2011
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