Individual
LUIS DAVID VELASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1401 MATTHEWS TOWNSHIP PKWY, STE 200, MATTHEWS, NC 28105-5402
(704) 384-6901
(704) 384-6902
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-6901
(704) 384-6902
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
31673
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110168797
RR MEDICARE
NC
05
—
1447284831
—
NC
01
—
84899
BC BS NC
NC
05
—
8984899
—
NC
05
—
N31673
—
SC
01
—
P00399299
RR MEDICARE
NC
Enumeration date
07/10/2006
Last updated
08/10/2016
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