Healthcare Provider Details

I. General information

NPI: 1720643810
Provider Name (Legal Business Name): CHRISTIAN WILLIAM ROEHMER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

Provider Other Name: CHRISTIAN ROEHMER MD

II. Dates (important events)

Enumeration Date: 05/05/2019
Last Update Date: 08/23/2024
Certification Date: 08/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

111 DOCTORS DR
GREENVILLE SC
29605-5622
US

IV. Provider business mailing address

300 E MCBEE AVE FL 4
GREENVILLE SC
29601-2842
US

V. Phone/Fax

Practice location:
  • Phone: 864-797-7100
  • Fax: 864-797-7105
Mailing address:
  • Phone: 989-330-3380
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2081P2900X
TaxonomyPain Medicine (Physical Medicine & Rehabilitation) Physician
License Number93029
License Number StateSC
# 3
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number62717
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: