| Doctor Name: | DR. MICHAEL R KOCH |
| NPI Number: | 1164408845 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | MD |
| License Number: | 2676 |
| Business Practice Address: | 1305 W 18th St Sioux Falls, SD - 571050401 |
| Business Phone Number: | 6053331720 |
| Business Fax Number: | 6053331966 |
| Mailing Address: | Po Box 5074, SIOUX FALLS |
| State: | SD |
| Postal Code: | 571175074 |
| Phone Number: | 6053286585 |
| Fax Number: | 6053286512 |
| NPI Enumeration Date: | 12/15/2005 |
| NPI Last Update Date: | 05/30/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 174400000X |
| License Number: | 2676 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | SD |
| Taxonomy Type: | Other Service Providers |
| Taxonomy Classification: | Specialist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |