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Individual
ROBERT W SMITH
Active
Individual
ROBERT W SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
22105
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000482949
BC/BS PAY TO #
WV
01
—
001767862
BLUE CROSS/BLUE SHIELD
WV
05
—
3810001067
—
WV
05
—
3810002521
—
WV
01
—
WV22105
HEALTH PLAN
WV
Enumeration date
02/22/2006
Last updated
01/15/2016
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