MEDICARE: DR. MARK E VELARDE MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	MD063905L	PA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00221679	OTHER	PA	PALMETTO GBA MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	1521387	OTHER	PA	GATEWAY HEALTH PLAN
3	50046210	OTHER	PA	CAPITAL BLUE CROSS
4	682317	OTHER	PA	HIGHMARK PA BLUE SHIELD

General Provider Information

NPI Number	:	1578513560
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARK E VELARDE MD

Provider Business Mailing Address
First Line	:	1605 N CEDAR CREST BLVD
Second Line	:	SUITE 110B
City	:	ALLENTOWN
State	:	PA
Zip	:	18104-2351
Country	:	US
Telephone Number	:	610-973-1410
Fax Number	:	610-973-1449

Provider Business Practice Location Address
First Line	:	6081 HAMILTON BLVD STE 101
Second Line	:
City	:	WESCOSVILLE
State	:	PA
Zip	:	18106-9801
Country	:	US
Telephone Number	:	610-395-0600
Fax Number	:	484-403-4018

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/11/2006
Last Update Date	:	10/04/2017

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Directions to “ DR. MARK E VELARDE MD” Practice Location

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