Provider Demographics
NPI:1942274964
Name:ELMORE, KELLY OBERIA (MD)
Entity Type:Individual
Prefix:
First Name:KELLY
Middle Name:OBERIA
Last Name:ELMORE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:10314 GROSVENOR PL
Mailing Address - Street 2:
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20852-4754
Mailing Address - Country:US
Mailing Address - Phone:773-398-6867
Mailing Address - Fax:
Practice Address - Street 1:WALTER REED NATIONAL MILITARY MEDICAL CENTER
Practice Address - Street 2:8901 WISCONSIN AVENUE
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:301-295-2427
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA105818207V00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology