Provider Demographics
NPI:1295069078
Name:MORGAN, CHAD CHRISTOPHER RAYMOND (OD)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:CHRISTOPHER RAYMOND
Last Name:MORGAN
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 1:7100 SIX FORKS RD
Mailing Address - Street 2:SUITE 301
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27615-6156
Mailing Address - Country:US
Mailing Address - Phone:919-847-0187
Mailing Address - Fax:919-676-2231
Practice Address - Street 1:110 CAPCOM AVE
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-6531
Practice Address - Country:US
Practice Address - Phone:919-556-1909
Practice Address - Fax:919-556-6765
Is Sole Proprietor?:No
Enumeration Date:2009-09-25
Last Update Date:2013-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2161152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC0930POtherBLUE CROSS BLUE SHIELD NORTH CAROLINA
NC5914237Medicaid
NC2484617IMedicare PIN
NC2484617KMedicare PIN
NC2484617RMedicare PIN
NC2484617WMedicare PIN
NC5914237Medicaid
NC2484617MMedicare PIN
NCNC2948AMedicare PIN
NC2484617LMedicare PIN
NC2484617FMedicare PIN
NC0930POtherBLUE CROSS BLUE SHIELD NORTH CAROLINA
NC2484617EMedicare PIN
NC2484617JMedicare PIN