Provider Demographics
NPI:1144271941
Name:TROCHELMAN, R DOUGLAS (MD)
Entity type:Individual
Prefix:DR
First Name:R
Middle Name:DOUGLAS
Last Name:TROCHELMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:161 N FORGE ST
Mailing Address - Street 2:STE. 198
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1468
Mailing Address - Country:US
Mailing Address - Phone:330-376-1043
Mailing Address - Fax:330-376-9951
Practice Address - Street 1:161 N FORGE ST
Practice Address - Street 2:STE. 198
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1468
Practice Address - Country:US
Practice Address - Phone:330-376-1043
Practice Address - Fax:330-376-9951
Is Sole Proprietor?:No
Enumeration Date:2006-05-15
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35049857207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH300583337001OtherMMOH
OH0617153OtherMEDICARE ID
OH0705044Medicaid
OH341587155BOtherACHS
OH000000134682OtherANTHEM
OH110029259OtherRR MEDICARE
OH793693OtherUHC
OHTRO617151OtherMEDICARE ID
OH7328574OtherAETNA
OH0617153OtherMEDICARE ID