Individual
JUAN CARLOS VELASCO-TRUJILLO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1500 MATTHEWS TOWNSHIP PKWY, MATTHEWS, NC 28105-4656
(704) 384-5416
(704) 384-5992
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-5416
(704) 384-5992
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2010-01148
NC
207R00000X
Internal Medicine Physician
TL30094
SC
208M00000X
Hospitalist Physician
Primary
2010-01148
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300944
—
SC
05
—
5916052
—
NC
01
—
P00437847
RAIL ROAD MEDICARE
SC
Enumeration date
07/18/2007
Last updated
10/25/2020
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