Individual
DR. ANDREW M LUXENBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
659 BOULEVARD ST, DOVER, OH 44622-2026
(330) 602-0767
(330) 365-3831
Mailing address
4665 DOUGLAS CIR NW STE 100, CANTON, OH 44718-3673
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
35064090
OH
207P00000X
Emergency Medicine Physician
35064090L
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000162489
ANTHEM
OH
05
—
0903991
—
OH
01
—
P00774259
MEDICARE RAILROAD
OH
Enumeration date
12/20/2005
Last updated
04/03/2019
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