Provider Demographics
NPI:1528475621
Name:KELMENDI, ADRIANNA (MD)
Entity type:Individual
Prefix:DR
First Name:ADRIANNA
Middle Name:
Last Name:KELMENDI
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 1:900 WILSHIRE DR
Mailing Address - Street 2:SUITE 103
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48084-1634
Mailing Address - Country:US
Mailing Address - Phone:248-635-9371
Mailing Address - Fax:
Practice Address - Street 1:12303 DE PAUL DR
Practice Address - Street 2:
Practice Address - City:BRIDGETON
Practice Address - State:MO
Practice Address - Zip Code:63044-2512
Practice Address - Country:US
Practice Address - Phone:314-344-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-21
Last Update Date:2021-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAMD-47098207Q00000X
MI4301106118207Q00000X
FLME.137326207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine