MEDICARE: DR. MARCELA BOHM-VELEZ M.D.

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	2085R0202X	Diagnostic Radiology Physician	MD027358E	PA
2	2085U0001X	Diagnostic Ultrasound Physician	MD027358E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0004084978	OTHER	PA	AETNA ID #
2	B0155322	OTHER	PA	HIGHMARK ID #
3	16553	OTHER	PA	HEALTH AMERICA ID

General Provider Information

NPI Number	:	1376543314
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARCELA BOHM-VELEZ M.D.

Provider Business Mailing Address
First Line	:	1910 COCHRAN RD
Second Line	:	MANOR OAK TWO, SUITE 740
City	:	PITTSBURGH
State	:	PA
Zip	:	15220-1203
Country	:	US
Telephone Number	:	412-440-6999
Fax Number	:	412-440-6998

Provider Business Practice Location Address
First Line	:	1910 COCHRAN RD
Second Line	:	MANOR OAK TWO, SUITE 740
City	:	PITTSBURGH
State	:	PA
Zip	:	15220-1203
Country	:	US
Telephone Number	:	412-440-6999
Fax Number	:	412-440-6998

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	08/11/2016

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Directions to “ DR. MARCELA BOHM-VELEZ M.D.” Practice Location

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