Individual
KEVIN J KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2701 BLAIR MILL RD, SUITE 6, WILLOW GROVE, PA 19090-1041
(215) 293-8800
(215) 293-9053
Mailing address
1804 THORNBURY DR, MAPLE GLEN, PA 19002-2842
(215) 628-4530
(215) 619-7159
Taxonomy
Speciality
Code
Description
License number
State
2080P0206X
Pediatric Gastroenterology Physician
Primary
MD-057754-L
PA
Other
Enumeration date
08/04/2005
Last updated
07/08/2007
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