Provider Demographics
NPI:1174054431
Name:AZBELL, ROBERTA (MD)
Entity type:Individual
Prefix:
First Name:ROBERTA
Middle Name:
Last Name:AZBELL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ROBERTA
Other - Middle Name:C
Other - Last Name:GOMEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:700 ACKERMAN RD STE 2120
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43202-1559
Mailing Address - Country:US
Mailing Address - Phone:614-293-9441
Mailing Address - Fax:614-293-6420
Practice Address - Street 1:181 TAYLOR AVE FL 13
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43203-1779
Practice Address - Country:US
Practice Address - Phone:614-293-9441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-03-27
Last Update Date:2025-04-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35142143207RH0000X, 207RH0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0453507Medicaid