Provider Demographics
NPI:1881663607
Name:MORESCHI, CHAD CHRISTOPHER (OD)
Entity Type:Individual
Prefix:DR
First Name:CHAD
Middle Name:CHRISTOPHER
Last Name:MORESCHI
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 1:147 S MAIN ST
Mailing Address - Street 2:P.O. BOX 67
Mailing Address - City:COLUMBIANA
Mailing Address - State:OH
Mailing Address - Zip Code:44408-1349
Mailing Address - Country:US
Mailing Address - Phone:330-482-2424
Mailing Address - Fax:330-482-2989
Practice Address - Street 1:147 S MAIN ST
Practice Address - Street 2:
Practice Address - City:COLUMBIANA
Practice Address - State:OH
Practice Address - Zip Code:44408-1349
Practice Address - Country:US
Practice Address - Phone:330-482-2424
Practice Address - Fax:330-482-2989
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-15
Last Update Date:2008-09-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHOH 4770152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2008419Medicaid
OH2008419Medicaid
1251680001Medicare NSC
MO0843422Medicare PIN