Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | 35.071838 | OH |
N | 2080P0205X | Pediatric Endocrinologist | 35.071838 | OH |
NPI | 1235527219 |
---|---|
Provider Name | Robert Shalwitz |
First Address | Bexley, OH 43209-2135 |
Second Address | Bexley, OH 43209-2135 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 29/12/2014 |
Last Update Date | 29/12/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
35.071838 | STATE MEDICAL BOARD OF OHIO (01) | OH |