Provider Demographics
NPI:1780134940
Name:KELAGHAN, JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:
Last Name:KELAGHAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 R ST NW APT 601
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009-1615
Mailing Address - Country:US
Mailing Address - Phone:202-709-7658
Mailing Address - Fax:
Practice Address - Street 1:1800 R ST NW APT 601
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-1615
Practice Address - Country:US
Practice Address - Phone:202-709-7658
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-11
Last Update Date:2016-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD148812083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
DC14881OtherMEDICAL LICENSE
DCCS-88-01352OtherDC CONTROLLED SUBSTANCES LICENSE