Provider Demographics
NPI:1134542400
Name:VELDMAN, JEROLD PAUL (MD)
Entity type:Individual
Prefix:DR
First Name:JEROLD
Middle Name:PAUL
Last Name:VELDMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4436 COPPERHILL DR
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-2000
Mailing Address - Country:US
Mailing Address - Phone:517-336-7128
Mailing Address - Fax:517-336-7128
Practice Address - Street 1:4436 COPPERHILL DR
Practice Address - Street 2:
Practice Address - City:OKEMOS
Practice Address - State:MI
Practice Address - Zip Code:48864-2000
Practice Address - Country:US
Practice Address - Phone:517-336-7128
Practice Address - Fax:517-336-7128
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-22
Last Update Date:2014-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301023916208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics