Provider Demographics
NPI:1205339009
Name:HARMAN, KELSEY MICHELLE (MD)
Entity type:Individual
Prefix:MRS
First Name:KELSEY
Middle Name:MICHELLE
Last Name:HARMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:KELSEY
Other - Middle Name:MICHELLE
Other - Last Name:COOK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1 WYOMING ST STE 4110
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45409-2722
Mailing Address - Country:US
Mailing Address - Phone:937-208-5665
Mailing Address - Fax:937-208-5669
Practice Address - Street 1:1 WYOMING ST STE 4110
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45409-2722
Practice Address - Country:US
Practice Address - Phone:937-208-5665
Practice Address - Fax:937-208-5669
Is Sole Proprietor?:No
Enumeration Date:2018-03-18
Last Update Date:2022-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
OH35.143266207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program