Axelrod, Robert C

Axelrod, Robert C is an individual health care provider with primary practice located at 600 Broadway St , Longview WA 98632-3256. He recently has only one registered license in Allopathic & Osteopathic Physicians / Psychiatry, which is considered as his primary health care specialty. Axelrod, Robert C can be contacted via phone (360) 414-2236.

Contact Information

Primary practice address
600 Broadway St Longview WA 98632-3256
Phone: (360) 414-2236
Fax: (360) 414-2788
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X MD00042630 Washington

Profile Details

NPI number 1285628099
LBN Legal business name Axelrod, Robert C
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 7th, 2005
Last updated Jul 9th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1285628099 NPPES
Oregon MEDICAID 227372
Oregon MEDICAID 8370652
Oregon Other P00071313
Oregon Other 0174698
Oregon Other 8933608

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