Provider Demographics
NPI:1447244835
Name:REX, ANNE MARGARET (DO)
Entity Type:Individual
Prefix:DR
First Name:ANNE
Middle Name:MARGARET
Last Name:REX
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:842 CORPORATE WAY
Mailing Address - Street 2:STE. 850
Mailing Address - City:WESTLAKE
Mailing Address - State:OH
Mailing Address - Zip Code:44145-1537
Mailing Address - Country:US
Mailing Address - Phone:440-871-4700
Mailing Address - Fax:440-871-4702
Practice Address - Street 1:34820 CHARDON RD
Practice Address - Street 2:
Practice Address - City:WILLOUGHBY
Practice Address - State:OH
Practice Address - Zip Code:44094-9103
Practice Address - Country:US
Practice Address - Phone:440-944-5700
Practice Address - Fax:440-944-7849
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-31
Last Update Date:2019-01-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH34007880207QS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QS0010XAllopathic & Osteopathic PhysiciansFamily MedicineSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2691814Medicaid
OH2691814Medicaid
OHH97733Medicare UPIN