Provider Demographics
NPI:1922580463
Name:ISAACSSON VELHO, PEDRO HENRIQUE (MD)
Entity Type:Individual
Prefix:DR
First Name:PEDRO
Middle Name:HENRIQUE
Last Name:ISAACSSON VELHO
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 1:929 N WOLFE ST UNIT 513
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21205-1151
Mailing Address - Country:US
Mailing Address - Phone:443-554-2578
Mailing Address - Fax:
Practice Address - Street 1:201 NORTH BROADWAY
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21287
Practice Address - Country:US
Practice Address - Phone:410-955-8893
Practice Address - Fax:410-614-7287
Is Sole Proprietor?:No
Enumeration Date:2018-08-31
Last Update Date:2018-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program