Provider Demographics
NPI:1760442610
Name:MAXWELL, CATHERINE S (MD)
Entity Type:Individual
Prefix:
First Name:CATHERINE
Middle Name:S
Last Name:MAXWELL
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 1:75 ARCH ST
Mailing Address - Street 2:STE. G2
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44304-1429
Mailing Address - Country:US
Mailing Address - Phone:330-375-4100
Mailing Address - Fax:330-375-4097
Practice Address - Street 1:75 ARCH ST
Practice Address - Street 2:STE. G2
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44304-1429
Practice Address - Country:US
Practice Address - Phone:330-375-4100
Practice Address - Fax:330-375-4097
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2011-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-044804207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000132187OtherANTHEM
OH0883123OtherMEDICARE ID
OH0646359Medicaid
OH0405451OtherUNITED HEALTHCARE
OH341458069CMOtherSUMMA CARE
OH729761OtherBUCKEYE COMMUNITY HEALTH
OH0883122OtherMEDICARE ID
OH380001328OtherRAILROAD MEDICARE
OH4008725OtherAETNA
OH0405451OtherUNITED HEALTHCARE