Kelly, Kevin James

Kelly, Kevin James is an individual health care provider with primary practice located at 8145 Valleywood Ln Suite B, Portage MI 49024-5296. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Kelly, Kevin James can be contacted via phone (269) 324-9162.

Contact Information

Primary practice address
8145 Valleywood Ln Suite B Portage MI 49024-5296
Phone: (269) 324-9162
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 4301039833 Michigan

Profile Details

NPI number 1710942479
LBN Legal business name Kelly, Kevin James
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 18th, 2006
Last updated Jul 9th, 2007 - about 18 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 1710942479 NPPES
Michigan Other 1103900222 BLUE CROSS BLUE SHIELD OF

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