Provider Demographics
NPI:1235527219
Name:SHALWITZ, ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:
Last Name:SHALWITZ
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2549 BRYDEN RD
Mailing Address - Street 2:
Mailing Address - City:BEXLEY
Mailing Address - State:OH
Mailing Address - Zip Code:43209-2135
Mailing Address - Country:US
Mailing Address - Phone:614-715-1860
Mailing Address - Fax:
Practice Address - Street 1:2549 BRYDEN RD
Practice Address - Street 2:
Practice Address - City:BEXLEY
Practice Address - State:OH
Practice Address - Zip Code:43209-2135
Practice Address - Country:US
Practice Address - Phone:614-715-1860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-29
Last Update Date:2014-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.071838208000000X, 2080P0205X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0205XAllopathic & Osteopathic PhysiciansPediatricsPediatric Endocrinology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH35.071838OtherSTATE MEDICAL BOARD OF OHIO