Healthcare Provider Details

I. General information

NPI: 1750465290
Provider Name (Legal Business Name): ROCHUS KEN-ICHI VOELLER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2006
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

640 JACKSON ST - MC 11503K HEHEALTHPARTNERS REGIONS SPECIALTY CLINICS
ST. PAUL MN
55101-2502
US

IV. Provider business mailing address

8170 33RD AVE S MS21110Q
MINNEAPOLIS MN
55425-4516
US

V. Phone/Fax

Practice location:
  • Phone: 651-254-2987
  • Fax: 651-254-1603
Mailing address:
  • Phone: 952-883-5375
  • Fax: 651-254-1603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number55496
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: