MEDICARE: DR. WILLIAM FISH MARSTELLER III D.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	999	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	9503227001	OTHER	OH	CIGNA
2	000000010694	OTHER	OH	ANTHEM BC/BS PIN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	311072809 1211	OTHER	OH	ANTHEM ADVANTAGE
5	311072809-00	OTHER	OH	OHIO BWC

General Provider Information

NPI Number	:	1548252893
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WILLIAM FISH MARSTELLER III D.C.

Provider Business Mailing Address
First Line	:	145 S MAIN ST
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45458-2370
Country	:	US
Telephone Number	:	937-433-4800
Fax Number	:	937-433-2618

Provider Business Practice Location Address
First Line	:	145 S MAIN ST
Second Line	:
City	:	CENTERVILLE
State	:	OH
Zip	:	45458-2370
Country	:	US
Telephone Number	:	937-433-4800
Fax Number	:	937-433-2618

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/22/2005
Last Update Date	:	07/08/2007

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