Basic Information
| Provider Information | |||||||||
| NPI: | 1144271941 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TROCHELMAN | ||||||||
| FirstName: | R | ||||||||
| MiddleName: | DOUGLAS | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 161 N FORGE ST | ||||||||
| Address2: | STE. 198 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443041468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303761043 | ||||||||
| FaxNumber: | 3303769951 | ||||||||
| Practice Location | |||||||||
| Address1: | 161 N FORGE ST | ||||||||
| Address2: | STE. 198 | ||||||||
| City: | AKRON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 443041468 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3303761043 | ||||||||
| FaxNumber: | 3303769951 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/15/2006 | ||||||||
| LastUpdateDate: | 11/28/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RX0202X | 35049857 | OH | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Medical Oncology |
ID Information
| ID | Type | State | Issuer | Description | 300583337001 | 01 | OH | MMOH | OTHER | 0617153 | 01 | OH | MEDICARE ID | OTHER | 0705044 | 05 | OH | MEDICAID | 341587155B | 01 | OH | ACHS | OTHER | 000000134682 | 01 | OH | ANTHEM | OTHER | 110029259 | 01 | OH | RR MEDICARE | OTHER | 793693 | 01 | OH | UHC | OTHER | TRO617151 | 01 | OH | MEDICARE ID | OTHER | 7328574 | 01 | OH | AETNA | OTHER |