Provider Demographics
NPI:1659685741
Name:VELDHOUSE, JOEL PATRICK (MD)
Entity Type:Individual
Prefix:
First Name:JOEL
Middle Name:PATRICK
Last Name:VELDHOUSE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3587 12TH ST
Mailing Address - Street 2:
Mailing Address - City:WAYLAND
Mailing Address - State:MI
Mailing Address - Zip Code:49348-9569
Mailing Address - Country:US
Mailing Address - Phone:269-792-2263
Mailing Address - Fax:269-792-4344
Practice Address - Street 1:3587 12TH ST
Practice Address - Street 2:
Practice Address - City:WAYLAND
Practice Address - State:MI
Practice Address - Zip Code:49348-9569
Practice Address - Country:US
Practice Address - Phone:616-648-4933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-07-30
Last Update Date:2023-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301097379208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics