DR. MAUREEN A KELLY (NPI# 1609874064) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1609874064 |
| Entity Type | Individual |
| Full Name | DR. MAUREEN A KELLY |
| Credential | MD |
| Practice Address |
43205 Woodward Ave Bloomfield Hills MI 48302-5006 |
| Mailing Address |
Po Box 44047 Detroit MI 48244-0047 |
| Practice Telephone | 2484510600 |
| Practice Fax Number | 2484510700 |
| Mailing Telephone | 2484510600 |
| Mailing Fax Number | 2484510700 |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2009-04-29 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208000000X | Pediatrics | 4301056543 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 4183802 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255403838 | Maureen Kelly | Social Worker | 977 Summit Ave, Saint Paul, MN 55105-3032 | 2006-11-15 |
| 1881664902 | Maureen C Kelly | Physician Assistant | 960 Main St, Branford, CT 06405-3730 | 2006-01-23 |
| 1518943554 | Maureen E Kelly | Internal Medicine | 4491 Bent Brothers Blvd., Colorado City, CO 81019-9990 | 2005-12-21 |
| 1578549671 | Maureen Elizabeth Kelly | Physical Therapist | 8317 N Hartman St, Portland, OR 97203-1103 | 2005-12-20 |
| 1902458052 | Maureen Kelly | Behavioral Analyst | 33 Turnpike Rd, Southborough, MA 01772-2108 | 2019-07-09 |
| 1912428723 | Maureen E Kelly | Family Medicine | 12251 S 80th Ave, Palos Heights, IL 60463-1256 | 2017-06-30 |
| 1811443062 | Maureen Kelly | Counselor | 1555 E Flamingo Rd, Suite 158, Las Vegas, NV 89119-5258 | 2016-08-28 |
| 1235473125 | Maureen Kelly | Counselor | 281 Independence Blvd, Suite 326, Virginia Beach, VA 23462-2986 | 2012-11-16 |
| 1154613578 | Maureen L. Kelly | Social Worker | 175 High St, Newton, NJ 07860-1004 | 2011-05-03 |
| 1043533185 | Maureen Kelly | Licensed Practical Nurse | 3007 Ely Ave, Bronx, NY 10469-3259 | 2010-03-03 |
| Street Address |
43205 WOODWARD AVE |
| City | BLOOMFIELD HILLS |
| State | MI |
| Zip Code | 48302-5006 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1437157955 | Sonja M Earles | Pediatrics | 43205 Woodward Ave, Bloomfield Hills, MI 48302-5006 | 2005-07-08 |
| 1275959652 | Kathleen Marie Kochanowicz | Nurse Practitioner | 43205 Woodward Ave, Bloomfield Hills, MI 48302 | 2014-03-10 |
| 1710199864 | Jennifer Gray Castro | Pediatrics | 43205 Woodward Ave, Bloomfield Hills, MI 48302-5006 | 2007-05-03 |
| 1295743920 | Ian Howard Fox | Pediatrics | 43205 Woodward Ave, Bloomfield Hills, MI 48302-5006 | 2006-08-05 |
| 1700884814 | Maureen A Kelly Md Pllc | Pediatrics | 43205 Woodward Ave, Bloomfield Hills, MI 48302-5006 | 2005-07-12 |
| 1174521538 | Sheila Rao | Pediatrics | 43205 Woodward Ave, Bloomfield Hills, MI 48302-5006 | 2005-07-11 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386242634 | Lamuriel Lewis | Registered Nurse | 1430 South Telegraph Rd, Bloomfield Hills, MI 48302 | 2020-10-09 |
| 1730794082 | Ola Glezen | Registered Nurse | 1410 South Telegraph Road, Bloomfield Hills, MI 48302 | 2020-09-14 |
| 1114563400 | Henry Ford Health System | Pharmacy | 1961 S Telegraph Rd, Bloomfield Twp, MI 48302 | 2019-11-21 |
| 1508407982 | P-cor LLC | Eyewear Supplier (Equipment, not the service) | 1961 S. Telegraph Rd, Bloomfield Hills, MI 48302 | 2019-10-07 |
| 1144887936 | Christine Beth Wilson De Medina | Psychologist | W-4111 Andover Road, Bloomfield Hills, MI 48302 | 2019-05-28 |
| 1942793799 | Andrew Joseph Grix | Physical Therapist | 2525 S Telegraph Rd Ste 314, Bloomfield Hills, MI 48302 | 2018-06-06 |
| 1306398078 | Shaleene Mayo | Mechanotherapist | 43902 Woodward # 120, Bloomfield Hills, MI 48302 | 2016-10-28 |
| 1588112981 | Carol Van Kampen | Social Worker | 2550 S. Telegraph, Bloomfield Hills, MI 48302 | 2016-09-14 |
| 1770933848 | Rachelle Savalli | Family Medicine | 1961 South Telegraph Rd, Bloomfield Twp, MI 48302 | 2016-06-20 |
| 1699155366 | Aleksey Mishulin | Ophthalmology | 1750 S Telegraph Ste 205, Bloomfield Hills, MI 48302 | 2015-06-08 |
| Find all providers in zip 48302 | ||||
| Taxonomy Code | 208000000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Pediatrics |
| A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Pediatrics, 2007. http://www.abp.org/. American Osteopathic Board of Pediatrics, 2007. http://www.osteopathic.org/certificatio - Board certification for Medical Doctors (MDs) is provided by the American Board of Pediatrics. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Pediatrics. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1598900896 | Niru Prasad | Pediatrics | 264 Pine Ridge Dr, Bloomfield Hills, MI 48304-2137 | 2008-12-16 |
| 1770604928 | Preeti Thabolingam | Pediatrics | 43750 Woodward Ste 104, Bloomfield Hills, MI 48302-5063 | 2007-04-03 |
| 1134292469 | Poonam Goel | Pediatrics | 3072 Woodcreek Way, Bloomfield Hills, MI 48304-1862 | 2006-11-16 |
| 1285678730 | Alita Rene Rice | Pediatrics | 71 E Long Lake Rd, Bloomfield Hills, MI 48304-9996 | 2006-06-15 |
| 1841234622 | Fidelina Nitura Baraceros | Pediatrics | 43750 Woodward Ave, Ste 104, Bloomfield Hills, MI 48302-5063 | 2006-06-15 |
| 1215937925 | Stanford Alvin Singer | Pediatrics | 36700 Woodward Ave, Ste 300, Bloomfield Hills, MI 48304-0926 | 2005-07-22 |
| 1437157955 | Sonja M Earles | Pediatrics | 43205 Woodward Ave, Bloomfield Hills, MI 48302-5006 | 2005-07-08 |
| 1508358896 | Tara Elizabeth Kristock | Pediatrics | 71 E Long Lake Rd, Bloomfield Hills, MI 48304-9996 | 2018-06-01 |
| 1669922977 | Serenity Pediatrics | Pediatrics | 71 E Long Lake Rd, Bloomfield Hills, MI 48304-9996 | 2016-10-11 |
| 1245650043 | Simi Pullukat | Pediatrics | 71 E Long Lake Rd, Bloomfield Hills, MI 48304-9996 | 2014-04-18 |
| Find all providers in BLOOMFIELD HILLS | ||||
| City | BLOOMFIELD HILLS |
| Zip Code | 48302 |
Please comment or provide details below to improve the information on DR. MAUREEN A KELLY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.