Individual
KELLY VICTORIA RENNIE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1201 WASHINGTON ST E, SUITE 208, CHARLESTON, WV 25301-1834
(304) 388-7270
Mailing address
1201 WASHINGTON ST E, SUITE 208, CHARLESTON, WV 25301-1834
(304) 388-7270
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
PGY.1.TUL-SURG
LA
2086S0127X
Trauma Surgery Physician
Primary
26075
WV
Other
Enumeration date
11/06/2007
Last updated
09/26/2014
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