Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0201X | Internist - Allergy & Immunology | 2708 | SD |
NPI | 1538113337 |
---|---|
Provider Name | Robert Maclean Smith |
First Address | Sioux Falls, SD 57117-5126 |
Second Address | Sioux Falls, SD 57108-2288 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/05/2006 |
Last Update Date | 15/06/2016 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0006934 | BCBS (01) | SD |
030003144 | RR MEDICARE (01) | SD |
0968362 | (05) | IA |
250705600 | (05) | MN |
4436 | BCBS (01) | NE |
5900242 | (05) | SD |
94159 | BCBS (01) | IA |
A02694 | (02) |