Provider Demographics
NPI:1790959930
Name:COLELLA, JOSEPH JOHN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:JOHN
Last Name:COLELLA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:17008 BARN RIDGE DR
Mailing Address - Street 2:
Mailing Address - City:SILVER SPRING
Mailing Address - State:MD
Mailing Address - Zip Code:20906-1178
Mailing Address - Country:US
Mailing Address - Phone:301-570-4977
Mailing Address - Fax:301-570-4978
Practice Address - Street 1:17008 BARN RIDGE DR
Practice Address - Street 2:
Practice Address - City:SILVER SPRING
Practice Address - State:MD
Practice Address - Zip Code:20906-1178
Practice Address - Country:US
Practice Address - Phone:301-570-4977
Practice Address - Fax:301-570-4978
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-18
Last Update Date:2017-06-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD0014399207LC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207LC0200XAllopathic & Osteopathic PhysiciansAnesthesiologyCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD016951000Medicaid
MD016951000Medicaid