Individual
JAMES KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
29466 PINTAIL DR, SUITE 5, EASTON, MD 21601-9323
(443) 515-0580
Mailing address
PO BOX 2878, EASTON MD, EASTON, MD 21601-8953
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
H0036293
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0685356 00
—
MD
Enumeration date
02/15/2017
Last updated
02/15/2017
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