Provider Demographics
NPI:1427126960
Name:VELLA, DAVID F (MD)
Entity type:Individual
Prefix:
First Name:DAVID
Middle Name:F
Last Name:VELLA
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 1:8391 COMMERCE RD
Mailing Address - Street 2:SUITE 108
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382-4489
Mailing Address - Country:US
Mailing Address - Phone:248-360-8100
Mailing Address - Fax:248-360-8018
Practice Address - Street 1:HENRY FORD HEALTH SYSTEM
Practice Address - Street 2:6777 WEST MAPLE ROAD
Practice Address - City:WEST BLOOMFIELD
Practice Address - State:MI
Practice Address - Zip Code:48323
Practice Address - Country:US
Practice Address - Phone:248-661-6455
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-01
Last Update Date:2021-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI054177207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI284782310Medicaid
700H262220OtherBLUE CROSS-BLUE CROSS
DV054177OtherCOMMERCIAL-COMMERCIAL NUMBER
DV054177OtherCHAMPUS-CHAMPUS
700H262220OtherBLUE CROSS-BLUE CROSS
MI284782310Medicaid