Organization
KIM A KELLY, M.D., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIM A KELLY MD (OWNER)
(301) 702-2003
Entity
Organization
Contact information
Practice address
5875 ALLENTOWN RD, SUITLAND, MD 20746-4570
(301) 702-2003
(301) 702-2324
Mailing address
5875 ALLENTOWN RD, SUITLAND, MD 20746-4570
(301) 702-2003
(301) 702-2324
Taxonomy
Speciality
Code
Description
License number
State
405300000X
Prevention Professional
Primary
D0039363
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048510100
—
MD
01
—
44400001
BLUE CHOICE
MD
Enumeration date
04/07/2016
Last updated
05/04/2017
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