Provider Demographics
NPI:1962412213
Name:MORESCHI, RAFAEL M (MD)
Entity type:Individual
Prefix:MR
First Name:RAFAEL
Middle Name:M
Last Name:MORESCHI
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 1:111 RONSARD LN
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511
Mailing Address - Country:US
Mailing Address - Phone:919-524-0082
Mailing Address - Fax:919-467-2238
Practice Address - Street 1:105-A KILMAYNE DRIVE
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511
Practice Address - Country:US
Practice Address - Phone:919-467-2253
Practice Address - Fax:919-467-2238
Is Sole Proprietor?:No
Enumeration Date:2006-08-09
Last Update Date:2007-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC25378207R00000X
NC64010207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8960627Medicaid
NC8960627Medicaid
NC2332688Medicare PIN