Most Relevant Information
Provider Data
| NPI Number: | 1003804907 |
| Provider Name: | KEITH MCNELLIS MD |
| Entity Type: | Individual |
| Taxonomy Code: | 207R00000X |
| Specialty: | Internal Medicine |
| License Number: | MD422449 |
Most Important Dates
| Enumeration Date: | 10/13/2005 |
| Last Updated: | 04/10/2018 |
Provider Practice Location
3401 N BROAD ST
PHILADELPHIA
PA
191405103
Practice Location Phone/Fax
| Phone: | 2157071622 |
| Fax: | 2157070943 |
Provider Mailing Location
2450 W HUNTING PARK AVE
PHILADELPHIA
PA
191291302
Provider Mailing Phone/Fax
| Phone: | 2157071622 |
| Fax: | 2157070943 |
Suggested EMR
Internist EMR