Individual
KELSEY MAYRAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1244 MEADOW BRIDGE DR STE 100, BEAVERCREEK, OH 45434-6388
(937) 208-7600
(937) 208-7620
Mailing address
2261 PHILADELPHIA DR, DAYTON, OH 45406-1814
(937) 734-4141
(937) 277-7249
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35.139593
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0405964
—
OH
Enumeration date
04/11/2017
Last updated
10/26/2020
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