Provider Demographics
NPI:1942628268
Name:LASCESKI, CHAD (MD)
Entity Type:Individual
Prefix:
First Name:CHAD
Middle Name:
Last Name:LASCESKI
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 1:4466 W BRISTOL RD
Mailing Address - Street 2:
Mailing Address - City:FLINT
Mailing Address - State:MI
Mailing Address - Zip Code:48507-3170
Mailing Address - Country:US
Mailing Address - Phone:810-733-1200
Mailing Address - Fax:810-733-3130
Practice Address - Street 1:307 S COURT ST
Practice Address - Street 2:
Practice Address - City:LAPEER
Practice Address - State:MI
Practice Address - Zip Code:48446-2514
Practice Address - Country:US
Practice Address - Phone:810-667-6110
Practice Address - Fax:810-667-3917
Is Sole Proprietor?:No
Enumeration Date:2014-04-03
Last Update Date:2020-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA260703207X00000X
MI4301501801207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery