Provider Demographics
NPI:1215908686
Name:LOHR, MICHELE M (MD)
Entity type:Individual
Prefix:
First Name:MICHELE
Middle Name:M
Last Name:LOHR
Suffix:
Gender:F
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:PO BOX 5074
Mailing Address - Street 2:
Mailing Address - City:SIOUX FALLS
Mailing Address - State:SD
Mailing Address - Zip Code:57117-5074
Mailing Address - Country:US
Mailing Address - Phone:605-328-6001
Mailing Address - Fax:605-328-6045
Practice Address - Street 1:1309 W 17TH ST
Practice Address - Street 2:
Practice Address - City:SIOUX FALLS
Practice Address - State:SD
Practice Address - Zip Code:57104-4663
Practice Address - Country:US
Practice Address - Phone:605-328-6001
Practice Address - Fax:605-328-6045
Is Sole Proprietor?:No
Enumeration Date:2006-02-01
Last Update Date:2022-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN478762085R0001X
SD75692085R0202X, 2085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
No2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
I33749Medicare UPIN