Individual
RYAN LAROCHELLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15 LOWELL ST, PORTLAND, ME 04102-2792
(207) 774-8277
Mailing address
2 OAK GLEN CT, MADISON, WI 53717-1605
(207) 852-1441
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
81645
WI
207W00000X
Ophthalmology Physician
Primary
MD28531
ME
207WX0200X
Ophthalmic Plastic and Reconstructive Surgery Physician
81645
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1568921302
—
WI
Enumeration date
03/19/2019
Last updated
09/15/2025
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