Provider Demographics
NPI:1255317277
Name:LOESCHER, ROLF C (MD)
Entity type:Individual
Prefix:
First Name:ROLF
Middle Name:C
Last Name:LOESCHER
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 1:4770 WINTERBERRY PL
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:IN
Mailing Address - Zip Code:47201-9731
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2003 STULTS RD STE 215
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:IN
Practice Address - Zip Code:46750-1291
Practice Address - Country:US
Practice Address - Phone:260-355-3960
Practice Address - Fax:260-355-3969
Is Sole Proprietor?:No
Enumeration Date:2005-12-21
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01036582A207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000512128OtherANTHEM
IN100384010AMedicaid
IN000000984535OtherANTHEM PIN
INF21821Medicare UPIN
250560EMedicare PIN
IN000000512128OtherANTHEM