Provider Demographics
NPI:1578581948
Name:VESS, STEVEN (DO)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:
Last Name:VESS
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 MAPLEWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:RONCEVERTE
Mailing Address - State:WV
Mailing Address - Zip Code:24970-1334
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:200 MAPLEWOOD AVE
Practice Address - Street 2:
Practice Address - City:RONCEVERTE
Practice Address - State:WV
Practice Address - Zip Code:24970-1334
Practice Address - Country:US
Practice Address - Phone:304-647-1175
Practice Address - Fax:304-647-3807
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-17
Last Update Date:2009-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV1263207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV5181107OtherFIRST HEALTH
WV60023OtherSOUTHERN HEALTH
WV004333000Medicaid
WV282427OtherANTHEM BCBS
WV200027625OtherRAILROAD MEDICARE
WV791098001OtherCIGNA
WV5943144OtherAETNA
WV030OtherMTST BCBS
WV249442OtherMAMSI
WV004333000Medicaid
WV030OtherMTST BCBS
WVVE0806741Medicare ID - Type Unspecified