Individual
GAIL MARIE KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
102 W. WATER STREET, SUITE 1, NEMOURS DUPONT PEDIATRICS, DOVER, DOVER, DE 19904-6750
(302) 651-6212
(302) 651-4945
Mailing address
PO BOX 191, PROVIDER ENROLLMENT DEPT, ROCKLAND, DE 19732-0191
(302) 651-6212
(302) 651-4945
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
C10010301
DE
208000000X
Pediatrics Physician
ME98073
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
278341000
—
FL
01
—
C10010301
STATE LICENSE
DE
Enumeration date
06/14/2007
Last updated
06/19/2013
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