Miller, Kelly L
Miller, Kelly L is an individual health care provider with primary practice located at 1417 Madison Park Drive , Glen Burnie MD 21061. She recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is her primary health care specialty. Miller, Kelly L can be contacted via phone (410) 768-6600.Contact Information
Primary practice address
1417 Madison Park Drive
Glen Burnie MD 21061
Phone: (410) 768-6600
Fax: (410) 553-0710
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | D61418 | Maryland |
| Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | D61418 | Maryland |
Profile Details
| NPI number | 1205897287 |
|---|---|
| LBN Legal business name | Miller, Kelly L |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 30th, 2006 |
| Last updated | Mar 19th, 2012 - about 14 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 | 1205897287 | NPPES |
| Maryland | MEDICAID | 004362100 | |
| Maryland | Other | P00434480 |
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