Healthcare Provider Details

I. General information

NPI: 1144271941
Provider Name (Legal Business Name): R DOUGLAS TROCHELMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/15/2006
Last Update Date: 11/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

161 N FORGE ST STE. 198
AKRON OH
44304-1468
US

IV. Provider business mailing address

161 N FORGE ST STE. 198
AKRON OH
44304-1468
US

V. Phone/Fax

Practice location:
  • Phone: 330-376-1043
  • Fax: 330-376-9951
Mailing address:
  • Phone: 330-376-1043
  • Fax: 330-376-9951

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License Number35049857
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: