Provider Demographics
NPI:1528043528
Name:SOLHEIM, VESNA (MD)
Entity Type:Individual
Prefix:DR
First Name:VESNA
Middle Name:
Last Name:SOLHEIM
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VESNA
Other - Middle Name:
Other - Last Name:TOMOVICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:12082 HIGHWAY 17 BYP B
Mailing Address - Street 2:
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
Is Sole Proprietor?:No
Enumeration Date:2005-12-13
Last Update Date:2018-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2004-00990207Q00000X
OH35-07-7373207Q00000X
SC30634207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8913708Medicaid
NCH29240Medicare UPIN
NC2032782AMedicare PIN
NC2340085Medicare ID - Type UnspecifiedMEDICARE LEGACY NUMBER