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NPI Code Detail

MEDICARE: KELSEY POSSLEY M.D.

MEDICARE: KELSEY POSSLEY M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084N0008XNeuromuscular Medicine (Psychiatry & Neurology) Physician4301504225MI
22084N0400XNeurology Physician4301504225MI

General Provider Information

NPI Number : 1609238294
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELSEY POSSLEY M.D.
Provider Business Mailing Address
First Line : 100 MICHIGAN ST NE # MC845
Second Line :
City : GRAND RAPIDS
State : MI
Zip : 49503-2560
Country : US
Telephone Number : 804-828-9783
Fax Number :
Provider Business Practice Location Address
First Line : SHMG NEUROLOGY AND CLINICAL NEUROPSYCHOLOGY, 3RD FLOOR
Second Line : 2750 E. BELTLINE NE
City : GRAND RAPIDS
State : MI
Zip : 49525-8614
Country : US
Telephone Number : 616-267-7104
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/23/2016
Last Update Date : 05/27/2026

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