Provider Demographics
NPI:1245452473
Name:KELLY, H VINCENT (MD)
Entity type:Individual
Prefix:DR
First Name:H
Middle Name:VINCENT
Last Name:KELLY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:HAROLD
Other - Middle Name:VINCENT
Other - Last Name:KELLY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:4300 EAST WEST HIGHWAY
Mailing Address - Street 2:LOWER LEVEL H VINCENT KELLY MD PA
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20814
Mailing Address - Country:US
Mailing Address - Phone:301-657-3992
Mailing Address - Fax:301-657-5501
Practice Address - Street 1:4300 EAST WEST HIGHWAY
Practice Address - Street 2:LOWER LEVEL H VINCENT KELLY MD PA
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20814
Practice Address - Country:US
Practice Address - Phone:301-657-3992
Practice Address - Fax:301-657-5501
Is Sole Proprietor?:No
Enumeration Date:2007-05-03
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD00062432084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDD0006243OtherMD LICENSE
MDD0006243OtherMD LICENSE
179855Medicare ID - Type Unspecified
AK4684963OtherDEA