Provider Demographics
NPI:1215909643
Name:MCDONALD, CHAD EVERETT (OD)
Entity type:Individual
Prefix:DR
First Name:CHAD
Middle Name:EVERETT
Last Name:MCDONALD
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 1:33 LOW ST
Mailing Address - Street 2:
Mailing Address - City:NEWBURYPORT
Mailing Address - State:MA
Mailing Address - Zip Code:01950-4048
Mailing Address - Country:US
Mailing Address - Phone:978-462-2020
Mailing Address - Fax:978-462-4263
Practice Address - Street 1:33 LOW ST
Practice Address - Street 2:
Practice Address - City:NEWBURYPORT
Practice Address - State:MA
Practice Address - Zip Code:01950-4048
Practice Address - Country:US
Practice Address - Phone:978-462-2020
Practice Address - Fax:978-462-4263
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-01
Last Update Date:2012-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA4087152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA405740OtherTUFTS
MAVMA000316OtherAVESIS
MA151952OtherHARVARD PILGRIM
MA542065263OtherTRICARE
MA542065263OtherUNITED HEALTHCARE
MA542065263OtherHEALTHCARE VALUE MANAGEME
MA387140OtherCIGNA
MA0023858OtherNEIGHBORHOOD HEALTH PLAN
MA2330207OtherAETNA
MA0317501Medicaid
MA542065263OtherINTEGRATED HEALTH PLAN
MAW20320OtherBLUE CROSS BLUE SHIELD
MA2330207OtherAETNA
MA542065263OtherUNITED HEALTHCARE