Provider Demographics
NPI:1255446845
Name:HARTWIG, ROBERT H (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:H
Last Name:HARTWIG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4235 SECOR RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43623
Mailing Address - Country:US
Mailing Address - Phone:419-885-2553
Mailing Address - Fax:
Practice Address - Street 1:6444 MONROE ST
Practice Address - Street 2:STE 1
Practice Address - City:SYLVANIA
Practice Address - State:OH
Practice Address - Zip Code:43560-1455
Practice Address - Country:US
Practice Address - Phone:419-885-2553
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2017-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35-04-4789 H207XS0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0431401Medicaid
C01874Medicare UPIN
OHHA0480484Medicare PIN