Provider Demographics
NPI:1861717548
Name:KELLAR, JESSE ZANE (MD)
Entity type:Individual
Prefix:DR
First Name:JESSE
Middle Name:ZANE
Last Name:KELLAR
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2000 GREEN RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48105-1598
Mailing Address - Country:US
Mailing Address - Phone:909-362-3567
Mailing Address - Fax:734-686-6344
Practice Address - Street 1:2000 GREEN RD
Practice Address - Street 2:SUITE 300
Practice Address - City:ANN ARBOR
Practice Address - State:MI
Practice Address - Zip Code:48105-1598
Practice Address - Country:US
Practice Address - Phone:909-362-3567
Practice Address - Fax:734-686-6344
Is Sole Proprietor?:No
Enumeration Date:2010-04-06
Last Update Date:2013-07-15
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301102563207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine