Individual
DR. ROBERT A MAXWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
979 E 3RD ST, STE 300, CHATTANOOGA, TN 37403
(423) 267-0466
(423) 778-8168
Mailing address
979 E 3RD ST, STE 300, CHATTANOOGA, TN 37403-2136
(423) 267-0466
(423) 778-8168
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD29718
TN
2086S0102X
Surgical Critical Care Physician
MD29718
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00859097B
—
GA
05
—
009910780
—
AL
01
—
020042396
RR MEDICARE
—
01
—
1740398
UHC
—
05
—
2536536
—
OH
01
—
3125384
BCBS OF TN
—
05
—
3829392
—
TN
01
—
62165877440
JDH
—
01
—
6333337 002
CIGNA
—
05
—
790608U
—
NC
Enumeration date
09/08/2005
Last updated
02/19/2019
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