Provider Demographics
NPI:1790784536
Name:KIELTY, DAVID W (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:W
Last Name:KIELTY
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:365 FAUNCE CORNER RD
Mailing Address - Street 2:
Mailing Address - City:N DARTMOUTH
Mailing Address - State:MA
Mailing Address - Zip Code:02747-6230
Mailing Address - Country:US
Mailing Address - Phone:508-985-6600
Mailing Address - Fax:508-995-1152
Practice Address - Street 1:365 FAUNCE CORNER RD
Practice Address - Street 2:
Practice Address - City:N DARTMOUTH
Practice Address - State:MA
Practice Address - Zip Code:02747-6230
Practice Address - Country:US
Practice Address - Phone:508-985-6600
Practice Address - Fax:508-995-1152
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-14
Last Update Date:2013-10-02
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Provider Licenses
StateLicense IDTaxonomies
MA157456207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA6055590001Medicare NSC