Dr. Michael J Kellum
Emergency Physician Emergency Medical Services
W9575 Homburg Lane
Whitewater
, Wisconsin 53190
Dr. Michael J Kellum
Emergency Physician Emergency Medical Services
W9575 Homburg Lane
Whitewater
, Wisconsin 53190
(262) 473-0961
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About
Features
Specialties
- Emergency Physician
- Emergency Medical Services
Languages spoken
- English
Location
First Address
- Dr. Michael J Kellum
- W9675 Homburg Ln
- Whitewater, WI
- Zip : 53190-3702
- Phone : (262) 473-0961
Second Address
- Dr. Michael J Kellum
- W9575 Homburg Lane
- Whitewater, WI
- Zip : 53190
- Phone : (262) 473-0961
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207P00000X | Emergency Physician | 36138-020 | WI |
| N | 207PE0004X | Emergency Medical Services | 36138-020 | WI |
National Provider Identifier
| NPI | 1164599387 |
|---|---|
| Provider Name | Dr. Michael J Kellum |
| First Address | Whitewater, WI 53190-3702 |
| Second Address | Whitewater, WI 53190 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 30/11/2006 |
| Last Update Date | 24/07/2015 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.