Provider Demographics
NPI:1053843870
Name:MARSH, VINCENT CHRISTOPHER
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:CHRISTOPHER
Last Name:MARSH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 MDG/SGHJ 4881 SUGAR MAPLE DR., WRIGHT-PATTERSON AFB,
Mailing Address - Street 2:
Mailing Address - City:WRIGHT PATTERSON AIR FORCE BASE
Mailing Address - State:OH
Mailing Address - Zip Code:45433
Mailing Address - Country:US
Mailing Address - Phone:937-257-0770
Mailing Address - Fax:
Practice Address - Street 1:88 MDG/SGHJ 4881 SUGAR MAPLE DR., WRIGHT-PATTERSON AFB,
Practice Address - Street 2:
Practice Address - City:WRIGHT PATTERSON AIR FORCE BASE
Practice Address - State:OH
Practice Address - Zip Code:45433-4543
Practice Address - Country:US
Practice Address - Phone:937-257-0770
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-30
Last Update Date:2023-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.138448207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine