Provider Demographics
NPI:1841280260
Name:KELEMAN, RICHELLE LEIGH (MD)
Entity type:Individual
Prefix:DR
First Name:RICHELLE
Middle Name:LEIGH
Last Name:KELEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:RICHELLE
Other - Middle Name:LEIGH
Other - Last Name:KIDD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:750 E PARK AVE
Mailing Address - Street 2:
Mailing Address - City:COLUMBIANA
Mailing Address - State:OH
Mailing Address - Zip Code:44408-1448
Mailing Address - Country:US
Mailing Address - Phone:330-482-7045
Mailing Address - Fax:330-482-7044
Practice Address - Street 1:750 E PARK AVE
Practice Address - Street 2:SUITE A
Practice Address - City:COLUMBIANA
Practice Address - State:OH
Practice Address - Zip Code:44408-1448
Practice Address - Country:US
Practice Address - Phone:330-482-7045
Practice Address - Fax:330-482-7044
Is Sole Proprietor?:No
Enumeration Date:2005-10-26
Last Update Date:2022-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-08-2641-K208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2456-015Medicaid
OH2456-015Medicaid