Individual
DR. JOHN PAUL VELASCO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4614 COUNTRY CLUB RD, WINSTON SALEM, NC 27104-3520
(336) 716-3787
(336) 716-0222
Mailing address
PO BOX 602658, CHARLOTTE, NC 28260-2658
(336) 716-2011
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036.174129
IL
207Q00000X
Family Medicine Physician
2015-01625
NC
207Q00000X
Family Medicine Physician
4301100843
MI
207Q00000X
Family Medicine Physician
84941
WI
207R00000X
Internal Medicine Physician
Primary
2015-01625
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100303555
—
WI
Enumeration date
07/02/2012
Last updated
04/18/2025
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