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General NPI Number Information
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NPI Number | 1093034746
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Entity Type | Individual
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Provider Name | KEVIN KOEHLER MD
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Gender | Male
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Dates
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Enumeration Date | 05/20/2010
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Last Update Date | 10/18/2024
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Provider Practice Location Address
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Address Line | 104 INNOVATION DR STE 2000
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City | GREENVILLE
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State | SC
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Zip | 29607-5253
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Country | US
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Telephone | 864-603-6300
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Fax | 877-379-2919
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Provider Business Mailing Address
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Address Line | 26900 CEDAR RD
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City | BEACHWOOD
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State | OH
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Zip | 44122-1191
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Country | US
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Telephone | 216-839-2990
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Fax | 216-839-2975
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 35.121162
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207RH0000X
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Taxonomy Name | Hematology (Internal Medicine) Physician
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License Number | 35.121162
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 93279
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 207RX0202X
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Taxonomy Name | Medical Oncology Physician
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License Number | 35.121162
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number | 35.121162
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License Number State | OH
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