IndividualActive
Ethan Koch, MD
NPI 1023514007 · Pain Medicine Physician · Saint Cloud, MN
Provider details
- NPI number
- 1023514007
- Entity type
- Individual
- Primary specialty
- Pain Medicine PhysicianAllopathic & Osteopathic Physicians
- Credential
- MD
- Sex
- Male
- Sole proprietor
- No
- License
- 71757 (MN)
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Allopathic & Osteopathic Physicians
Practice location
4801 Veterans Dr
Saint Cloud, MN 56303-2015
Phone: (320) 252-1670
Approximate (ZIP-level) locationGet directions
Mailing address
4801 Veterans Dr
Saint Cloud, MN 56303-2015
Registry dates
- Enumerated
- 2018-03-30
- Last updated
- 2025-04-03
- Certified
- 2025-03-17
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.