Kellis, Michael J

Kellis, Michael J is an individual health care provider with primary practice located at 150 Seventh Ave Ste 200 , Chardon OH 44024-2909. He recently has only one registered license in Allopathic & Osteopathic Physicians / Sports Medicine, which is considered as his primary health care specialty. Kellis, Michael J can be contacted via phone (440) 285-4999.

Contact Information

Primary practice address
150 Seventh Ave Ste 200 Chardon OH 44024-2909
Phone: (440) 285-4999
Fax: (402) 855-8704
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 207RS0010X 34004183 Ohio

Profile Details

NPI number 1831190313
LBN Legal business name Kellis, Michael J
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 9th, 2005
Last updated Nov 2nd, 2023 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1831190313 NPPES
Ohio Other 139662 ANTHEM
Ohio Other 250006704 ANTHEM
Ohio MEDICAID 0658051 ANTHEM
Ohio Other 4073792 ANTHEM

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