Provider Demographics
NPI:1417978362
Name:VEL NATESAN MD PA
Entity Type:Organization
Organization Name:VEL NATESAN MD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VEL
Authorized Official - Middle Name:
Authorized Official - Last Name:NATESAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-749-4400
Mailing Address - Street 1:951 MOUNT HERMON RD STE A
Mailing Address - Street 2:
Mailing Address - City:SALISBURY
Mailing Address - State:MD
Mailing Address - Zip Code:21804-5159
Mailing Address - Country:US
Mailing Address - Phone:410-749-4400
Mailing Address - Fax:410-749-0847
Practice Address - Street 1:951 MOUNT HERMON RD STE A
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21804-5159
Practice Address - Country:US
Practice Address - Phone:410-749-4400
Practice Address - Fax:410-749-0847
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-23
Last Update Date:2012-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDLT64VAOtherBLUE SHIELD
MD767504600Medicaid
MD003MMedicare ID - Type Unspecified