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General NPI Number Information
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NPI Number | 1023087483
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Entity Type | Individual
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Provider Name | SEAN MICHAEL VELLUCCI MD
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Gender | Male
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Dates
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Enumeration Date | 03/16/2006
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Last Update Date | 01/28/2014
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Provider Practice Location Address
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Address Line | 5175 MORSE RD SUITE 400
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City | GAHANNA
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State | OH
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Zip | 43230-1370
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Country | US
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Telephone | 614-741-4411
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Fax | 614-741-4412
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Provider Business Mailing Address
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Address Line | 5175 MORSE RD SUITE 400
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City | GAHANNA
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State | OH
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Zip | 43230-1370
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Country | US
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Telephone | 614-741-4411
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Fax | 614-741-4412
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 35080611
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License Number State | OH
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