Provider Demographics
NPI:1841603172
Name:PENMETCHA, ROHAN (DO)
Entity Type:Individual
Prefix:DR
First Name:ROHAN
Middle Name:
Last Name:PENMETCHA
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:788 8TH AVENUE SE
Mailing Address - Street 2:SUITE 400
Mailing Address - City:CEDAR RAPIDS
Mailing Address - State:IA
Mailing Address - Zip Code:52401
Mailing Address - Country:US
Mailing Address - Phone:319-832-2328
Mailing Address - Fax:319-832-1168
Practice Address - Street 1:788 8TH AVENUE SE
Practice Address - Street 2:SUITE 400
Practice Address - City:CEDAR RAPIDS
Practice Address - State:IA
Practice Address - Zip Code:52401
Practice Address - Country:US
Practice Address - Phone:319-832-2328
Practice Address - Fax:319-832-1168
Is Sole Proprietor?:No
Enumeration Date:2014-06-04
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IADO-05569207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease