Individual
JOHN ROBERT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3458 NEELY RD, JB MDL, NJ 08641-5312
(609) 754-9010
Mailing address
3458 NEELY RD, JB MDL, NJ 08641-5312
(609) 754-9010
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
—
—
207P00000X
Emergency Medicine Physician
4301096499
MI
2083A0100X
Aerospace Medicine Physician
Primary
0101256097
VA
390200000X
Student in an Organized Health Care Education/Training Program
4301096499
MI
Other
Enumeration date
06/02/2010
Last updated
03/29/2022
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