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Individual

DR. MARSHALL CLAUDE WAREHAM

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5250 FAR HILLS AVE, SUITE 207, DAYTON, OH 45429-2382
(937) 433-2300
(937) 433-0210
Mailing address
5250 FAR HILLS AVE, SUITE 207, DAYTON, OH 45429-2382
(937) 433-2300
(937) 433-0210

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
35-05-0634-W
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000189353
ANTHEM BC/BS
OH
05
0770134
OH
01
180011133
RAILROAD MEDICARE
OH
01
22364
COLE VISION
OH
01
311026469027
CARESOURCE
OH
Enumeration date
07/13/2005
Last updated
03/12/2012
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