Provider Demographics
NPI:1295965499
Name:VELDT, MIRIAM YVONNE (MD)
Entity type:Individual
Prefix:DR
First Name:MIRIAM
Middle Name:YVONNE
Last Name:VELDT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 1239
Mailing Address - Street 2:
Mailing Address - City:TROY
Mailing Address - State:MI
Mailing Address - Zip Code:48099-1239
Mailing Address - Country:US
Mailing Address - Phone:248-824-6600
Mailing Address - Fax:248-324-1477
Practice Address - Street 1:2725 AIRVIEW BLVD
Practice Address - Street 2:SUITE 105
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49002-1085
Practice Address - Country:US
Practice Address - Phone:269-349-8386
Practice Address - Fax:269-349-8397
Is Sole Proprietor?:No
Enumeration Date:2009-07-22
Last Update Date:2013-08-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
MI4301095330207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine