Provider Demographics
NPI:1669655718
Name:CHAD G KELMAN MD PA
Entity type:Organization
Organization Name:CHAD G KELMAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHAD
Authorized Official - Middle Name:G
Authorized Official - Last Name:KELMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:561561-414-5892
Mailing Address - Street 1:5032 NW 24TH CIR
Mailing Address - Street 2:
Mailing Address - City:BOCA RATON
Mailing Address - State:FL
Mailing Address - Zip Code:33431-4330
Mailing Address - Country:US
Mailing Address - Phone:561-414-5892
Mailing Address - Fax:561-994-2559
Practice Address - Street 1:5032 NW 24TH CIR
Practice Address - Street 2:
Practice Address - City:BOCA RATON
Practice Address - State:FL
Practice Address - Zip Code:33431-4330
Practice Address - Country:US
Practice Address - Phone:561-414-5892
Practice Address - Fax:561-994-2559
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-12
Last Update Date:2007-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL779522085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic RadiologyGroup - Single Specialty