Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Ethan Benjamin Koch, MD

Individual provider Physical Medicine & Rehabilitation Physician · NPI 1023514007

Ethan Benjamin Koch, MD is a Physical Medicine & Rehabilitation Physician in Saint Cloud, Minnesota. Licensed in Minnesota. Registered with an NPI since 2018.

Licensed in
MN
In the registry since
2018
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

See every abbreviation used in this directory →

Practice location Address checks out

4801 Veterans Dr
Saint Cloud, MN 56303-2015
Phone: (320) 252-1670
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pain Medicine Physician (primary) Taxonomy 208VP0000X · Licence 71757 (MN)
Physical Medicine & Rehabilitation Physician Taxonomy 208100000X · Licence 71757 (MN)
General Practice Physician Taxonomy 208D00000X · Licence 71757 (MN)

Record details

NPI number1023514007
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 30, 2018
Last updated in NPPESApril 3, 2025
Certification dateMarch 17, 2025
Mailing address4801 Veterans Dr, Saint Cloud, MN 56303-2015

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