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General NPI Number Information
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NPI Number | 1295918910
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Entity Type | Organization
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Legal Business Name | MICHAEL W KELBER MD PC
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Dates
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Enumeration Date | 12/17/2007
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Last Update Date | 12/17/2007
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Provider Practice Location Address
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Address Line | 2365 GREAR ST NE
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City | SALEM
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State | OR
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Zip | 97301-2747
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Country | US
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Telephone | 503-391-6615
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Fax | 503-391-0471
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Provider Business Mailing Address
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Address Line | 2365 GREAR ST NE
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City | SALEM
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State | OR
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Zip | 97301-2747
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Country | US
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Telephone | 503-391-6615
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Fax | 503-391-0471
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. MICHAEL WILFORD KELBER
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Credential | MD
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Telephone | 503-391-6615
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 10647
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License Number State | OR
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