Provider Demographics
NPI:1801886965
Name:ROEHMHOLDT, JOHN M (MD)
Entity type:Individual
Prefix:DR
First Name:JOHN
Middle Name:M
Last Name:ROEHMHOLDT
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:3085 HARLEM RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:CHEEKTOWAGA
Mailing Address - State:NY
Mailing Address - Zip Code:14225-2591
Mailing Address - Country:US
Mailing Address - Phone:716-844-5600
Mailing Address - Fax:716-844-5750
Practice Address - Street 1:3085 HARLEM RD
Practice Address - Street 2:STE 200
Practice Address - City:CHEEKTOWAGA
Practice Address - State:NY
Practice Address - Zip Code:14225-2563
Practice Address - Country:US
Practice Address - Phone:716-844-5000
Practice Address - Fax:716-844-5050
Is Sole Proprietor?:No
Enumeration Date:2005-10-28
Last Update Date:2015-08-13
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Provider Licenses
StateLicense IDTaxonomies
NY167540208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY00010149702OtherUNIVERA
NY070322000078OtherFIDELIS
NYP00368540OtherRR MEDICARE
NY145176OtherWORKERS COMP
NY000527023004OtherBCBS OF WNY
NY1903219OtherIHA
NY00010149702OtherUNIVERA
NY070322000078OtherFIDELIS