Provider Demographics
NPI:1194724369
Name:MARCHESCHI, EDWARD A (MD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:A
Last Name:MARCHESCHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:8737 UNION CENTRE BLVD
Mailing Address - Street 2:MERCY HEALTH WELLINGTON ORTHOPAEDICS WEST CHESTER
Mailing Address - City:WEST CHESTER
Mailing Address - State:OH
Mailing Address - Zip Code:45069-4878
Mailing Address - Country:US
Mailing Address - Phone:513-645-2200
Mailing Address - Fax:
Practice Address - Street 1:3950 RED BANK RD
Practice Address - Street 2:SUITE 100
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45227-3429
Practice Address - Country:US
Practice Address - Phone:513-333-2580
Practice Address - Fax:513-333-2584
Is Sole Proprietor?:No
Enumeration Date:2005-07-19
Last Update Date:2015-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-080595207R00000X, 207RS0010X, 208M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0010XAllopathic & Osteopathic PhysiciansInternal MedicineSports Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH742097OtherBUCKEYE MEDICAID
OH773053OtherANTHEM
OH2296055OtherMEDICAID
OH273088817060OtherCARESOURCE
OH447596OtherWELLCARE
KY64045867Medicaid
OH7283343OtherAETNA
OH051015OtherBUCKEYE MEDICARD
OHH105760OtherMEDICARE
OHP01241847OtherRAILROAD MEDICARE