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General NPI Number Information
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NPI Number | 1811032378
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Entity Type | Individual
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Provider Name | HERBERT GEORGE ROEHRICH MD
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Gender | Male
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 05/01/2024
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Provider Practice Location Address
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Address Line | 300 68TH ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49548-6927
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Country | US
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Telephone | 616-455-5000
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Fax |
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Provider Business Mailing Address
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Address Line | 920 60TH ST
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City | KENOSHA
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State | WI
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Zip | 53140-4041
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Country | US
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Telephone | 262-654-5333
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Fax | 262-654-7818
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 29103
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 29103
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License Number State | WI
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