Provider Demographics
NPI:1548561830
Name:KELSEY, BEVERLY JOAN (MD)
Entity Type:Individual
Prefix:DR
First Name:BEVERLY
Middle Name:JOAN
Last Name:KELSEY
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:301 SAINT PAUL PL
Mailing Address - Street 2:POB #712
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21202-2102
Mailing Address - Country:US
Mailing Address - Phone:410-332-9195
Mailing Address - Fax:410-332-9655
Practice Address - Street 1:301 SAINT PAUL PL
Practice Address - Street 2:POB #712
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21202-2102
Practice Address - Country:US
Practice Address - Phone:410-332-9195
Practice Address - Fax:410-332-9655
Is Sole Proprietor?:No
Enumeration Date:2010-11-03
Last Update Date:2010-11-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MDD0032418207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine