Provider Demographics
NPI:1013991546
Name:MARTSOLF, ROBERT H
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
Last Name:MARTSOLF
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2415 AUBURN AVE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45219-2701
Mailing Address - Country:US
Mailing Address - Phone:513-221-4949
Mailing Address - Fax:513-241-4191
Practice Address - Street 1:2415 AUBURN AVE
Practice Address - Street 2:
Practice Address - City:CINCINNATI
Practice Address - State:OH
Practice Address - Zip Code:45219-2701
Practice Address - Country:US
Practice Address - Phone:513-241-4949
Practice Address - Fax:513-241-4191
Is Sole Proprietor?:No
Enumeration Date:2005-11-29
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD019516E207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0411138Medicaid
PA000549107Medicaid
OH0411138Medicaid
PA091355RN0Medicare PIN