NPI 1023514007

Ethan Benjamin Koch, MD

Practitioner Pain Medicine Physician Saint Cloud, MN

Practice location

Address: 4801 Veterans Dr, Saint Cloud, MN 56303-2015
Phone: (320) 252-1670

Registered specialties (3)

Pain Medicine Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 208VP0000X Licence 71757 (MN)

Other Pain Medicine providers in Minnesota →

Physical Medicine & Rehabilitation Physician

Allopathic & Osteopathic Physicians Taxonomy 208100000X Licence 71757 (MN)

Other Physical Medicine & Rehabilitation providers in Minnesota →

General Practice Physician

Allopathic & Osteopathic Physicians Taxonomy 208D00000X Licence 71757 (MN)

Other General Practice providers in Minnesota →

Registry record

NPI: 1023514007
Entity type: Individual
Sex (as registered): Male
NPI issued: 30 Mar 2018
Record last updated: 3 Apr 2025

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.