Provider Demographics
NPI:1184707523
Name:VOEGELE, LOTHAIRE DIETER (MD)
Entity type:Individual
Prefix:DR
First Name:LOTHAIRE
Middle Name:DIETER
Last Name:VOEGELE
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:PO BOX 476
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29802-0476
Mailing Address - Country:US
Mailing Address - Phone:803-641-4874
Mailing Address - Fax:803-641-1669
Practice Address - Street 1:137 MIRACLE DR
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-6351
Practice Address - Country:US
Practice Address - Phone:803-641-4874
Practice Address - Fax:803-641-1669
Is Sole Proprietor?:No
Enumeration Date:2006-10-21
Last Update Date:2014-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6529208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3562Medicaid
SCD17480Medicare UPIN
SCGP3562Medicaid