Individual
DR. MARC-ANTHONY Q VELILLA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6071 W OUTER DR, DETROIT, MI 48235-2624
(313) 966-3300
Mailing address
4201 SAINT ANTOINE ST, SUITE 3R, DETROIT, MI 48201-2153
(313) 745-3330
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
4301072274
MI
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
4301072274
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
104337800
—
MI
05
—
104337810
—
MI
01
—
MV072274
BC/BS OF MI
MI
Enumeration date
03/17/2006
Last updated
06/17/2010
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