Provider Demographics
NPI:1346216736
Name:ROTHWANGL, JOHANN (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHANN
Middle Name:
Last Name:ROTHWANGL
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 1:713 SMYTH RD
Mailing Address - Street 2:VAMC
Mailing Address - City:MANCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03104-7005
Mailing Address - Country:US
Mailing Address - Phone:603-624-4366
Mailing Address - Fax:603-626-6571
Practice Address - Street 1:718 SMYTH RD
Practice Address - Street 2:VAMC
Practice Address - City:MANCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03104-7007
Practice Address - Country:US
Practice Address - Phone:603-624-4366
Practice Address - Fax:603-626-6571
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-24
Last Update Date:2008-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH10220207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology