Mcnellis, Keith
Mcnellis, Keith is an individual health care provider with primary practice located at 3401 N Broad St , Philadelphia PA 19140-5103. He recently has only one registered license in Allopathic & Osteopathic Physicians / Internal Medicine, which is considered as his primary health care specialty. Mcnellis, Keith can be contacted via phone (215) 707-1622.Contact Information
Primary practice address
3401 N Broad St
Philadelphia PA 19140-5103
Phone: (215) 707-1622
Fax: (215) 707-0943
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | MD422449 | Pennsylvania |
Profile Details
| NPI number | 1003804907 |
|---|---|
| LBN Legal business name | Mcnellis, Keith |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2005 |
| Last updated | Apr 10th, 2018 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1003804907 | NPPES |
| Pennsylvania | MEDICAID | 1008228410061 |
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