Provider Demographics
NPI:1245298900
Name:ROHRER, DAVID M (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:M
Last Name:ROHRER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:807 BLUE JACKET DR
Mailing Address - Street 2:
Mailing Address - City:FORT RECOVERY
Mailing Address - State:OH
Mailing Address - Zip Code:45846-9790
Mailing Address - Country:US
Mailing Address - Phone:419-375-2112
Mailing Address - Fax:419-375-7003
Practice Address - Street 1:807 BLUE JACKET DR
Practice Address - Street 2:
Practice Address - City:FORT RECOVERY
Practice Address - State:OH
Practice Address - Zip Code:45846-9790
Practice Address - Country:US
Practice Address - Phone:419-375-2112
Practice Address - Fax:419-375-7003
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2010-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35067074207Q00000X
IN01043028207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH08142865OtherRAIL ROAD MEDICARE
OH2114545Medicaid
OH000000140749OtherBLUE CROSS BLUE SHIELD
IN200105880BMedicaid
OH000000140749OtherBLUE CROSS BLUE SHIELD
OH2114545Medicaid
OH4221961Medicare PIN