Healthcare Provider Details

I. General information

NPI: 1245298900
Provider Name (Legal Business Name): DAVID M ROHRER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/03/2006
Last Update Date: 08/18/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

807 BLUE JACKET DR
FORT RECOVERY OH
45846-9790
US

IV. Provider business mailing address

807 BLUE JACKET DR
FORT RECOVERY OH
45846-9790
US

V. Phone/Fax

Practice location:
  • Phone: 419-375-2112
  • Fax: 419-375-7003
Mailing address:
  • Phone: 419-375-2112
  • Fax: 419-375-7003

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35067074
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01043028
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: