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General NPI Number Information
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NPI Number | 1265708770
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Entity Type | Organization
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Legal Business Name | HAROLD VINCENT KELLY M.D., P.A.
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Dates
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Enumeration Date | 03/29/2012
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Last Update Date | 03/29/2012
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Provider Practice Location Address
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Address Line | 4300 EAST-WEST HIGHWAY LOWER LEVEL
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City | BETHESDA
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State | MD
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Zip | 20814-4433
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Country | US
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Telephone | 301-657-3992
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Fax | 301-657-5501
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Provider Business Mailing Address
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Address Line | 4300 EAST-WEST HIGHWAY LOWER LEVEL
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City | BETHESDA
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State | MD
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Zip | 20814-4433
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Country | US
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Telephone | 301-657-3992
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Fax | 301-657-5501
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Authorized Official
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Title or Position | OWNER
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Name | HAROLD VINCENT KELLY
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Credential | M.D.
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Telephone | 301-657-3992
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | D0006243
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License Number State | MD
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