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Individual
ROBIN L SMITH
Active
Individual
ROBIN L SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601001714
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0853312690
BLUE CROSS BLUE SHIELD
MI
01
—
0N61290003
MEDICARE ADVANTAGE
MI
Enumeration date
09/20/2006
Last updated
10/08/2009
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