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Individual

ROBERT C AXELROD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
600 BROADWAY ST, LONGVIEW, WA 98632-3256
(360) 414-2236
(360) 414-2788
Mailing address
PO BOX 249, LONGVIEW, WA 98632-7154
(360) 414-2048
(360) 575-6749

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD00042630
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0174698
LABOR & IND
WA
05
227372
OR
05
8370652
WA
01
8933608
CRIME VICTIMS
WA
01
P00071313
RR MEDICARE
Enumeration date
09/07/2005
Last updated
07/09/2007
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