Provider Demographics
NPI:1033278338
Name:MORESCHI, ANTHONY P (MD)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:P
Last Name:MORESCHI
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 1:302 N WESTBERRY ST
Mailing Address - Street 2:
Mailing Address - City:SYLVESTER
Mailing Address - State:GA
Mailing Address - Zip Code:31791-2125
Mailing Address - Country:US
Mailing Address - Phone:229-776-7060
Mailing Address - Fax:229-299-4217
Practice Address - Street 1:302 N WESTBERRY ST
Practice Address - Street 2:
Practice Address - City:SYLVESTER
Practice Address - State:GA
Practice Address - Zip Code:31791-2125
Practice Address - Country:US
Practice Address - Phone:229-776-7060
Practice Address - Fax:229-299-4217
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2024-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049146208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA210445OtherBLUE CROSS BLUE SHIELD
GA000888742FMedicaid
GA000888742CMedicaid
GA000888742FMedicaid
GA000888742CMedicaid