Individual
MARC C MCCULLOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
205 E PALMER RD, BELLEFONTAINE, OH 43311-2281
(937) 592-4015
Mailing address
266 MULADORE DR, POWELL, OH 43065-9388
(614) 496-1355
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
35052132
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000026809
ANTHEM
—
05
—
0632515
—
OH
01
—
341407259
NATIONWIDE
—
01
—
341407259037
MEDICAL MUTUAL
—
01
—
7755544
AETNA
—
01
—
87726
UHC
—
01
—
930068436
RR MEDICARE
—
01
—
MC7250901
TRICARE
—
Enumeration date
06/22/2006
Last updated
04/01/2009
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