Individual
THOMAS WILLIAM CHURCH
Active
Individual
THOMAS WILLIAM CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35.049094
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000177812
ANTHEM BCBS
OH
05
—
0758836
—
OH
01
—
300044081
RAILROAD MEDICARE
OH
01
—
300117621
RAILROAD MEDICARE
OH
Enumeration date
03/27/2006
Last updated
02/26/2019
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