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NPI Code Detail

MEDICARE: MARK J VELARDE PA-C

MEDICARE: MARK J VELARDE PA-C
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
1363AM0700XMedical Physician Assistant5601004901MI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11058112690OTHERMIBCBS INDIVIDUAL
20H14989OTHERMIBCBS GROUP

General Provider Information

NPI Number : 1477659423
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARK J VELARDE PA-C
Provider Business Mailing Address
First Line : 5300 ELLIOTT DR
Second Line :
City : YPSILANTI
State : MI
Zip : 48197-8632
Country : US
Telephone Number : 734-434-6262
Fax Number : 734-712-2820
Provider Business Practice Location Address
First Line : 5300 ELLIOTT DR
Second Line :
City : YPSILANTI
State : MI
Zip : 48197-8632
Country : US
Telephone Number : 734-434-6262
Fax Number : 734-712-2820
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/16/2006
Last Update Date : 12/15/2025

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