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General NPI Number Information
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NPI Number | 1184692444
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Entity Type | Individual
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Provider Name | SHARON SUE KELLY DO
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Gender | Female
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Dates
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Enumeration Date | 03/10/2006
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Last Update Date | 01/30/2008
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Provider Practice Location Address
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Address Line | 6116 E WARREN AVE
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City | DENVER
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State | CO
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Zip | 80222-5752
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Country | US
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Telephone | 303-512-0888
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Fax | 303-512-2288
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Provider Business Mailing Address
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Address Line | PO BOX 30309
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City | CHARLESTON
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State | SC
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Zip | 29417-0309
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Country | US
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Telephone | 843-284-3400
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Fax | 843-566-8780
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207ZB0001X
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Taxonomy Name | Blood Banking & Transfusion Medicine Physician
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License Number | 31623
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License Number State | CO
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Taxonomy #2
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 31623
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License Number State | CO
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