Provider Demographics
NPI:1205126125
Name:LAROCHELLE, PATRICK C (MD)
Entity type:Individual
Prefix:
First Name:PATRICK
Middle Name:C
Last Name:LAROCHELLE
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 1:3445 SEMINOLE TRL
Mailing Address - Street 2:STE 249
Mailing Address - City:CHARLOTTESVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:22911-5637
Mailing Address - Country:US
Mailing Address - Phone:434-933-3318
Mailing Address - Fax:972-646-9162
Practice Address - Street 1:3445 SEMINOLE TRL
Practice Address - Street 2:STE 249
Practice Address - City:CHARLOTTESVILLE
Practice Address - State:VA
Practice Address - Zip Code:22911-5637
Practice Address - Country:US
Practice Address - Phone:434-933-3318
Practice Address - Fax:972-646-9162
Is Sole Proprietor?:No
Enumeration Date:2011-04-12
Last Update Date:2021-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0101256792207R00000X, 208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program