Individual
DR. MARK D KELEMEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
22 S GREENE ST, BALTIMORE, MD 21201-1544
(410) 790-7690
(410) 328-8225
Mailing address
PO BOX 64442, BALTIMORE, MD 21264-4442
(410) 790-7690
(410) 328-8225
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
D45643
MD
207RI0011X
Interventional Cardiology Physician
D45643
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
037572100
—
DC
05
—
157011100
—
MD
05
—
1902850548
—
DE
05
—
3810000258
—
WV
01
—
532666-09
BLUE CROSS/BLUE SHIELD
MD
Enumeration date
05/19/2006
Last updated
11/03/2010
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