Individual
DR. CHARLES ROBERT KOEPKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1440 ROCKSIDE RD STE 202, PARMA, OH 44134
(216) 749-8276
(216) 749-8240
Mailing address
1440 ROCKSIDE RD STE 202, PARMA, OH 44134-2749
(216) 749-8276
(216) 749-8240
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35076187
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000184421
UNICARE- LIFE AND HEALTH
OH
01
—
110201424
RAILROAD MEDICARE
OH
05
—
2167542
—
OH
01
—
341847368033
CARESOURCE
OH
01
—
393446
WELLCARE OF OH
OH
01
—
P76187
SUMMACARE HEALTH PLAN
OH
Enumeration date
09/09/2005
Last updated
05/31/2018
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