Provider Demographics
NPI:1578513560
Name:VELARDE, MARK E (MD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:E
Last Name:VELARDE
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1605 N CEDAR CREST BLVD
Mailing Address - Street 2:SUITE 110B
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18104-2351
Mailing Address - Country:US
Mailing Address - Phone:610-973-1410
Mailing Address - Fax:610-973-1449
Practice Address - Street 1:6081 HAMILTON BLVD STE 101
Practice Address - Street 2:
Practice Address - City:WESCOSVILLE
Practice Address - State:PA
Practice Address - Zip Code:18106-9801
Practice Address - Country:US
Practice Address - Phone:610-395-0600
Practice Address - Fax:484-403-4018
Is Sole Proprietor?:No
Enumeration Date:2006-05-11
Last Update Date:2017-10-04
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Provider Licenses
StateLicense IDTaxonomies
PAMD063905L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAP00221679OtherPALMETTO GBA MEDICARE
PA1521387OtherGATEWAY HEALTH PLAN
PA50046210OtherCAPITAL BLUE CROSS
PA682317OtherHIGHMARK PA BLUE SHIELD
PA039912KZJMedicare PIN
PAP00221679OtherPALMETTO GBA MEDICARE
PA682317OtherHIGHMARK PA BLUE SHIELD