Provider Demographics
NPI:1396722443
Name:MAXWELL, MD, ROBERT JOSEPH II (MD)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:JOSEPH
Last Name:MAXWELL, MD
Suffix:II
Gender:M
Credentials:MD
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Mailing Address - Street 1:725 CLIFTON BLVD
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:OH
Mailing Address - Zip Code:44907-2284
Mailing Address - Country:US
Mailing Address - Phone:419-774-0295
Mailing Address - Fax:
Practice Address - Street 1:335 GLESSNER AVE FL 5
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:OH
Practice Address - Zip Code:44903-2269
Practice Address - Country:US
Practice Address - Phone:419-522-2833
Practice Address - Fax:419-524-1619
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2022-01-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OH35-068577208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000130382OtherANTHEM
OH0143937Medicaid
OH020028795OtherRAILROAD MEDICARE
OH000000130382OtherANTHEM