Provider Demographics
NPI:1174919997
Name:CHEMELEWSKI, KELSEY ELIZABETH (MD)
Entity type:Individual
Prefix:
First Name:KELSEY
Middle Name:ELIZABETH
Last Name:CHEMELEWSKI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8573 E SAN ALBERTO STE E100
Mailing Address - Street 2:
Mailing Address - City:SCOTTSDALE
Mailing Address - State:AZ
Mailing Address - Zip Code:85258-4612
Mailing Address - Country:US
Mailing Address - Phone:480-778-1732
Mailing Address - Fax:
Practice Address - Street 1:8573 E SAN ALBERTO STE E100
Practice Address - Street 2:
Practice Address - City:SCOTTSDALE
Practice Address - State:AZ
Practice Address - Zip Code:85258-4612
Practice Address - Country:US
Practice Address - Phone:480-778-1732
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-08
Last Update Date:2019-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
AZ56164208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training ProgramGroup - Single Specialty