Provider Demographics
NPI:1275566689
Name:VESA, ALLIN (MD)
Entity type:Individual
Prefix:
First Name:ALLIN
Middle Name:
Last Name:VESA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:171 FAIRVIEW RD
Mailing Address - Street 2:
Mailing Address - City:MOORESVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28117-9500
Mailing Address - Country:US
Mailing Address - Phone:704-660-4000
Mailing Address - Fax:
Practice Address - Street 1:4853 S SHERIDAN RD STE 612
Practice Address - Street 2:
Practice Address - City:TULSA
Practice Address - State:OK
Practice Address - Zip Code:74145-5760
Practice Address - Country:US
Practice Address - Phone:405-213-0192
Practice Address - Fax:405-438-0988
Is Sole Proprietor?:No
Enumeration Date:2006-07-09
Last Update Date:2025-05-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV15205207P00000X
MA257836207P00000X
AZ48777207P00000X
NC200300721207P00000X
CODR.0055340207P00000X
VA0101257604207P00000X
FLME122116207P00000X
OK37838207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89135ENMedicaid
SCN0072BMedicaid
SCN0072BMedicaid
NCH74483Medicare UPIN