Individual
DR. MATTHEW EUGENE THIEL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
109 HOUPT DR, UPPER SANDUSKY, OH 43351-9201
(419) 294-3489
(419) 294-2791
Mailing address
109 HOUPT DR, UPPER SANDUSKY, OH 43351-9201
(419) 294-3489
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1102
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000121332
ANTHEM BLUE CROSS
OH
01
—
2795088
MEDICAID-(INDIVIDUAL)
—
01
—
2882911
MEDICAID (GROUP)
—
01
—
311516923
COMMERCIAL CLAIMS
OH
01
—
31151692300
BWC PROVIDER NUMBER
OH
01
—
5840453
AETNA
OH
Enumeration date
07/31/2006
Last updated
03/07/2012
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