Individual
RICHARD I KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, PHD
Contact information
Practice address
707 N BROADWAY, BALTIMORE, MD 21205-1832
(443) 923-9200
(443) 923-9405
Mailing address
2931 E BIDDLE ST, PATIENT ACCOUNTING, BALTIMORE, MD 21213-3939
(443) 923-1886
(443) 923-1895
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
D36881
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
168471000
—
MD
01
—
52312401
CAREFIRST BC BS
MD
Enumeration date
12/20/2006
Last updated
10/15/2012
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