Individual
ROBERT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
416 DIVISION ST, SOUTH CHARLESTON, WV 25309-1456
(304) 766-7141
(304) 766-7143
Mailing address
1021 QUARRIER ST, STE 301, CHARLESTON, WV 25301-2313
(304) 343-4625
(304) 343-4626
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
14970
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0120020000
—
WV
Enumeration date
06/13/2005
Last updated
07/08/2007
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