Healthcare Provider Details

I. General information

NPI: 1174445878
Provider Name (Legal Business Name): ANDRE LAROCHELLE MD, PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 07/27/2026
Certification Date: 07/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9000 ROCKVILLE PIKE
BETHESDA MD
20892-0001
US

IV. Provider business mailing address

9000 ROCKVILLE PIKE
BETHESDA MD
20892-0001
US

V. Phone/Fax

Practice location:
  • Phone: 301-814-8289
  • Fax:
Mailing address:
  • Phone: 301-814-8289
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0000X
TaxonomyHematology (Internal Medicine) Physician
License NumberD0059581
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: