Provider Demographics
NPI:1386661395
Name:MOERSCHELL, PAUL G III (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:G
Last Name:MOERSCHELL
Suffix:III
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:291 INDEPENDENCE BLVD
Mailing Address - Street 2:STE 110
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-5476
Mailing Address - Country:US
Mailing Address - Phone:757-499-2389
Mailing Address - Fax:757-499-0696
Practice Address - Street 1:291 INDEPENDENCE BLVD
Practice Address - Street 2:STE 110
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-5476
Practice Address - Country:US
Practice Address - Phone:757-499-2389
Practice Address - Fax:757-499-0696
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2008-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618000226152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA009231609Medicaid
VA009231609Medicaid
VAT21940Medicare UPIN