Mirle A Kellett
Interventional Cardiology
96 Campus Dr Suite 1
Scarborough
, Maine 04074-7133
Mirle A Kellett
Interventional Cardiology
96 Campus Dr Suite 1
Scarborough
, Maine 04074-7133
(207) 396-8632
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About
Features
Specialties
- Interventional Cardiology
Languages spoken
- English
Location
First Address
- Mirle A Kellett
- 301c Us Route 1
- Scarborough, ME
- Zip : 04074-9701
- Fax : (207) 396-8632
- Phone : (207) 396-8600
Second Address
- Mirle A Kellett
- 96 Campus Dr Suite 1
- Scarborough, ME
- Zip : 04074-7133
- Phone : (207) 396-5611
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 207RI0011X | Interventional Cardiology | MD12317 | ME |
National Provider Identifier
| NPI | 1023088218 |
|---|---|
| Provider Name | Mirle A Kellett |
| First Address | Scarborough, ME 04074-9701 |
| Second Address | Scarborough, ME 04074-7133 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 23/01/2006 |
| Last Update Date | 26/11/2014 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| 282560099 | (05) | ME |
| D08891 | (02) | ME |
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.