GARY M. KELLMAN MD NPI 1104844760

NPI Information

NPI: 1104844760
Provider Name: GARY M. KELLMAN, MD
Classification: Radiology - 2085R0202X
Entity Type: Individual

Specialization: Diagnostic Radiology

PECOS Registration: Yes

Address:
2722 MERRILEE DR
#230
FAIRFAX, VA
ZIP 22031
Phone: (703) 698-4483
Get Directions

Gary M. Kellman, MD is a diagnostic radiology radiology in Fairfax, VA with 43 years of experience. The provider is a radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. Gary M. Kellman, MD NPI is 1104844760. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

2722 MERRILEE DR
#230
FAIRFAX, VA
ZIP 22031-400
Phone: (703) 698-4483
Fax: (703) 573-0880

The NPI 1104844760 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 7/18/2006 and was last updated on 5/18/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	2085B0100X	Radiology	Body Imaging	0101048839	VIRGINIA	No
2	2085N0700X	Radiology	Neuroradiology	0101048839	VIRGINIA	No
3	2085N0904X	Radiology	Nuclear Radiology	0101048839	VIRGINIA	No
4	2085P0229X	Radiology	Pediatric Radiology	0101048839	VIRGINIA	No
5	2085R0202X	Radiology	Diagnostic Radiology	D0087855	MARYLAND	No
6	2085R0202X	Radiology	Diagnostic Radiology	G183989	CALIFORNIA	No
7	2085R0204X	Radiology	Vascular & Interventional Radiology	0101048839	VIRGINIA	No
8	2085U0001X	Radiology	Diagnostic Ultrasound	0101048839	VIRGINIA	No
9	2085R0202X	Radiology	Diagnostic Radiology	0101048839	VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	0030	OTHER	VIRGINIA	CAREFIRST BCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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