Provider Demographics
NPI:1134161979
Name:VELARDE, DAVID MICHAEL (DPM)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:MICHAEL
Last Name:VELARDE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2824 MERCHANTS DR
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37912-4905
Mailing Address - Country:US
Mailing Address - Phone:865-523-1141
Mailing Address - Fax:865-521-6635
Practice Address - Street 1:2824 MERCHANTS DR
Practice Address - Street 2:
Practice Address - City:KNOXVILLE
Practice Address - State:TN
Practice Address - Zip Code:37912-4905
Practice Address - Country:US
Practice Address - Phone:865-523-1141
Practice Address - Fax:865-521-6635
Is Sole Proprietor?:No
Enumeration Date:2006-06-12
Last Update Date:2009-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN631213ES0131X
FLPO2652213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7644655OtherAETNA
TN8893748OtherCIGNA
TN3726396Medicaid
TNTN0102OtherUNITED HEALTHCARE ORG
TN4099765OtherBLUECROSS BLUE SHIELD
TNP00182231OtherRAILROAD MEDICARE
TN8893748OtherCIGNA
TN4099765OtherBLUECROSS BLUE SHIELD
TN3726396Medicaid