Provider Demographics
NPI:1699145524
Name:VESNA SOLHEIM, MD PC
Entity type:Organization
Organization Name:VESNA SOLHEIM, MD PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:VESNA
Authorized Official - Middle Name:
Authorized Official - Last Name:SOLHEIM
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-900-0777
Mailing Address - Street 1:12082 HIGHWAY 17 BYP
Mailing Address - Street 2:UNIT B
Mailing Address - City:MURRELLS INLET
Mailing Address - State:SC
Mailing Address - Zip Code:29576-9350
Mailing Address - Country:US
Mailing Address - Phone:843-900-0777
Mailing Address - Fax:843-900-0780
Practice Address - Street 1:12082 HIGHWAY 17 BYP
Practice Address - Street 2:UNIT B
Practice Address - City:MURRELLS INLET
Practice Address - State:SC
Practice Address - Zip Code:29576-9350
Practice Address - Country:US
Practice Address - Phone:843-900-0777
Practice Address - Fax:843-900-0780
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-10-05
Last Update Date:2015-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC8913708Medicaid
SC8913708Medicaid