Individual
DR. MICHAEL KELLY
Active
Individual
DR. MICHAEL KELLY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
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
Update your record
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