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Individual

DR. MICHAEL KELLY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1933 HYLAND ST, FERNDALE, MI 48220-3803
(248) 933-0558
Mailing address
1933 HYLAND ST, FERNDALE, MI 48220-3803

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4301065795
MI
207ZP0105X
Clinical Pathology/Laboratory Medicine Physician
Primary
86418
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
BLUE CROSS
340H275000
MI
01
COMMERICAL
382032989
MI
Enumeration date
12/01/2005
Last updated
03/20/2026
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