| Dr Michael M Kennelly, MD | |
|
16233 Sylvester Rd Sw Ste 110, Burien, WA 98166-3044 | |
| (206) 901-8980 | |
| Not Available |
| Full Name | Dr Michael M Kennelly |
|---|---|
| Gender | Male |
| Speciality | Surgery |
| Location | 16233 Sylvester Rd Sw Ste 110, Burien, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215996459 | NPI | - | NPPES |
| 1005224 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208600000X | Surgery | MD00021678 (Washington) | Primary |
| Entity Name | Franciscan Medical Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093165334 PECOS PAC ID: 0547173866 Enrollment ID: O20031111000789 |
| Entity Name | Proliance Surgeons Inc P S |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1023170313 PECOS PAC ID: 8527972900 Enrollment ID: O20031119000128 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Michael M Kennelly, MD 16233 Sylvester Rd Sw Ste 110, Burien, WA 98166-3044 Ph: (206) 901-8980 | Dr Michael M Kennelly, MD 16233 Sylvester Rd Sw Ste 110, Burien, WA 98166-3044 Ph: (206) 901-8980 |
Nathan Avery, MD Surgery Medicare: Accepting Medicare Assignments Practice Location: 16233 Sylvester Rd Sw Ste 110, Burien, WA 98166 Phone: 206-901-8980 | |
Mr. Vincent Nnaemeka Muoneke, MD Surgery Medicare: Medicare Enrolled Practice Location: 16233 Sylvester Rd Sw, Suite280, Burien, WA 98166 Phone: 206-248-6992 Fax: 253-984-6774 | |
Marco A. Sobrino, M.D., F.A.C.S. Surgery Medicare: Medicare Enrolled Practice Location: 16122 8th Ave Sw, Suite D1, Burien, WA 98166 Phone: 206-244-1680 Fax: 206-243-8845 | |
Erina Kansakar, M.D. Surgery Medicare: Accepting Medicare Assignments Practice Location: 16233 Sylvester Rd Sw Ste 110, Burien, WA 98166 Phone: 206-901-8980 Fax: 253-426-6344 |