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General NPI Number Information
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NPI Number | 1578513560
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Entity Type | Individual
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Provider Name | MARK E VELARDE MD
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Gender | Male
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 10/04/2017
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Provider Practice Location Address
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Address Line | 6081 HAMILTON BLVD STE 101
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City | WESCOSVILLE
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State | PA
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Zip | 18106-9801
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Country | US
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Telephone | 610-395-0600
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Fax | 484-403-4018
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Provider Business Mailing Address
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Address Line | 1605 N CEDAR CREST BLVD SUITE 110B
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City | ALLENTOWN
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State | PA
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Zip | 18104-2351
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Country | US
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Telephone | 610-973-1410
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Fax | 610-973-1449
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD063905L
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License Number State | PA
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