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Contact Information

CHARLES A KELLY, MD
40 SECOND AVE
WALTHAM, MA02451
 Phone: 617-726-3030
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Anesthesiology

207L00000X 79 Physician/Addiction Medicine
Indicates primary specialty

NPI Profile & details for CHARLES A KELLY · (Male)

NPI Number 1083674352
Status Active
Credentials MD
Entity Individual
Enumeration date 03/23/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 Not specified
Identifiers
  • MA License # 72670
  • MA Medicaid 3060926
  • MA Other J09601 BCBS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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