Provider Demographics
NPI:1154313385
Name:CARVER, CHRISTOPHER N (OD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:N
Last Name:CARVER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2591 WEXFORD BAYNE RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:SEWICKLEY
Mailing Address - State:PA
Mailing Address - Zip Code:15143-8676
Mailing Address - Country:US
Mailing Address - Phone:724-933-5588
Mailing Address - Fax:724-933-6051
Practice Address - Street 1:2591 WEXFORD BAYNE RD
Practice Address - Street 2:SUITE 104
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-8676
Practice Address - Country:US
Practice Address - Phone:724-933-5588
Practice Address - Fax:724-933-6051
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2013-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0EG000254152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA001733882Medicaid
U72191Medicare UPIN
PA018472Medicare ID - Type Unspecified