Provider Demographics
NPI:1740293216
Name:VELYVIS, JOHN HENRY (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:HENRY
Last Name:VELYVIS
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 1:1100 E CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:MARTINSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:24112-3225
Mailing Address - Country:US
Mailing Address - Phone:276-638-2354
Mailing Address - Fax:276-638-3398
Practice Address - Street 1:1100 E CHURCH ST
Practice Address - Street 2:
Practice Address - City:MARTINSVILLE
Practice Address - State:VA
Practice Address - Zip Code:24112-3225
Practice Address - Country:US
Practice Address - Phone:276-638-2354
Practice Address - Fax:276-638-3398
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-14
Last Update Date:2023-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA92235207X00000X, 207XS0114X
VA0101266016207X00000X, 207XS0114X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery
No207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A922350Medicare PIN
CAI10316Medicare UPIN