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Individual

WILLIAM R PROTZER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
30 E APPLE ST, SUITE 5254, DAYTON, OH 45409
(937) 208-4200
(937) 208-4205
Mailing address
30 E APPLE ST, SUITE 5254, DAYTON, OH 45409
(937) 208-4200
(937) 208-4205

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35062539
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000213793
BC/BS INDIVIDUAL PIN NO
OH
05
0913800
OH
01
30012319
RR MDCR PIN NUMBER
OH
Enumeration date
07/21/2005
Last updated
03/12/2013
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