Healthcare Provider Details

I. General information

NPI: 1447244835
Provider Name (Legal Business Name): ANNE MARGARET REX DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2005
Last Update Date: 01/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34820 CHARDON RD
WILLOUGHBY OH
44094-9103
US

IV. Provider business mailing address

842 CORPORATE WAY STE. 850
WESTLAKE OH
44145-1537
US

V. Phone/Fax

Practice location:
  • Phone: 440-944-5700
  • Fax: 440-944-7849
Mailing address:
  • Phone: 440-871-4700
  • Fax: 440-871-4702

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number34007880
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: