Individual
DR. ROBERT B KELLY
Active
Individual
DR. ROBERT B KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD 20525
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
150504
MARION POLK CHP
—
05
—
150504
—
OR
05
—
8209959
—
WA
01
—
A056
CHAMPUS
—
01
—
G53960
PROVIDENCE
—
01
—
M400721
PACIFIC SOURCE
—
Enumeration date
09/19/2006
Last updated
12/04/2007
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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