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NPI Code Detail

MEDICARE: DR. PEDRO VELASQUEZ MD

MEDICARE: DR. PEDRO VELASQUEZ 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
1207R00000XInternal Medicine Physician35089TN
2207RE0101XEndocrinology, Diabetes & Metabolism Physician35089TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1003874801
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PEDRO VELASQUEZ MD
Provider Business Mailing Address
First Line : 6074 APPLE TREE DR STE 10
Second Line :
City : MEMPHIS
State : TN
Zip : 38115-0300
Country : US
Telephone Number : 901-922-5951
Fax Number : 901-922-5952
Provider Business Practice Location Address
First Line : 1068 CRESTHAVEN RD STE 300
Second Line :
City : MEMPHIS
State : TN
Zip : 38119-0809
Country : US
Telephone Number : 901-683-0024
Fax Number : 901-683-0086
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/02/2006
Last Update Date : 04/06/2020

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