Individual
THOMAS WILLIAM CHURCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
730 W MARKET ST, LIMA, OH 45801-4602
(419) 227-3361
Mailing address
5700 SOUTHWYCK BLVD, TOLEDO, OH 43614-1509
(800) 288-8325
(419) 866-5453
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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