Provider Demographics
NPI:1548252893
Name:MARSTELLER, WILLIAM FISH III (DC)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:FISH
Last Name:MARSTELLER
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:145 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:CENTERVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45458-2370
Mailing Address - Country:US
Mailing Address - Phone:937-433-4800
Mailing Address - Fax:937-433-2618
Practice Address - Street 1:145 S MAIN ST
Practice Address - Street 2:
Practice Address - City:CENTERVILLE
Practice Address - State:OH
Practice Address - Zip Code:45458-2370
Practice Address - Country:US
Practice Address - Phone:937-433-4800
Practice Address - Fax:937-433-2618
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH999111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH9503227001OtherCIGNA
OH000000010694OtherANTHEM BC/BS PIN
OH0660735Medicaid
OH311072809 1211OtherANTHEM ADVANTAGE
OH311072809-00OtherOHIO BWC
OH9503227001OtherCIGNA
OHMAO537962Medicare ID - Type Unspecified