Individual
ROBERT G AXONOVITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
7640 SYLVANIA AVE, I, SYLVANIA, OH 43560-9729
(419) 517-4000
(419) 517-4001
Mailing address
7640 SYLVANIA AVE, I, SYLVANIA, OH 43560-9729
(419) 517-4000
(419) 517-4001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
35048851A
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000130367
ANTHEM BCBS
OH
01
—
01059
PARAMOUNT
OH
05
—
0540543
—
OH
01
—
4119606
AETNA
OH
01
—
795718
UNITED HEALTH CARE
OH
Enumeration date
08/03/2005
Last updated
10/16/2007
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