Provider Demographics
NPI:1518782374
Name:VELO MEDICAL GROUP LLC
Entity type:Organization
Organization Name:VELO MEDICAL GROUP LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:AFIYAH
Authorized Official - Middle Name:
Authorized Official - Last Name:HASHMI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-910-9196
Mailing Address - Street 1:301 GWINNETT DR SW, LAWRENCEVILLE, GA 30046
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046-5669
Mailing Address - Country:US
Mailing Address - Phone:770-910-9196
Mailing Address - Fax:770-910-9197
Practice Address - Street 1:301 GWINNETT DRIVE
Practice Address - Street 2:
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046
Practice Address - Country:US
Practice Address - Phone:770-910-9196
Practice Address - Fax:770-910-9197
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty