Provider Demographics
NPI:1407896236
Name:VALERO-COLON, CELIAN (MD)
Entity Type:Individual
Prefix:DR
First Name:CELIAN
Middle Name:
Last Name:VALERO-COLON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CELIAN
Other - Middle Name:
Other - Last Name:VALERO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:2900 SABRE ST STE 300
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23452-7380
Mailing Address - Country:US
Mailing Address - Phone:757-222-0300
Mailing Address - Fax:
Practice Address - Street 1:1840 REISTERSTOWN RD
Practice Address - Street 2:
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-1305
Practice Address - Country:US
Practice Address - Phone:757-222-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2019-01-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0063282208M00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDCA8374OtherR/R MEDICARE GROUP #
MD409095100Medicaid
MDP00328227OtherR/R MEDICARE PROVIDER #
MDCA8374OtherR/R MEDICARE GROUP #
MDI45991Medicare UPIN