Provider Demographics
NPI:1013350198
Name:LAROCHE, ELISE ROSE (MD)
Entity Type:Individual
Prefix:DR
First Name:ELISE
Middle Name:ROSE
Last Name:LAROCHE
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 781076
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48278-1076
Mailing Address - Country:US
Mailing Address - Phone:317-528-4800
Mailing Address - Fax:317-865-1479
Practice Address - Street 1:747 E COUNTY LINE RD STE D
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:IN
Practice Address - Zip Code:46143-1082
Practice Address - Country:US
Practice Address - Phone:317-888-9669
Practice Address - Fax:317-885-7966
Is Sole Proprietor?:No
Enumeration Date:2013-04-09
Last Update Date:2023-10-11
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Provider Licenses
StateLicense IDTaxonomies
IN01077253A207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine