Provider Demographics
NPI:1346877024
Name:VESOLE, ADAM SAMUEL (MD)
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:SAMUEL
Last Name:VESOLE
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 1:2490 HEATHER GLEN AVE
Mailing Address - Street 2:
Mailing Address - City:BETTENDORF
Mailing Address - State:IA
Mailing Address - Zip Code:52722-6217
Mailing Address - Country:US
Mailing Address - Phone:563-320-4371
Mailing Address - Fax:
Practice Address - Street 1:3400 SPRUCE ST FL 5
Practice Address - Street 2:
Practice Address - City:PHILADELPHIA
Practice Address - State:PA
Practice Address - Zip Code:19104-4229
Practice Address - Country:US
Practice Address - Phone:215-662-2137
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-03-24
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD488250207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology