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Individual

ROBERT P SMILANICH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1055 N 300 W, SUITE 205, PROVO, UT 84604-3374
(801) 374-9100
(801) 374-9117
Mailing address
1055 N 300 W, SUITE 205, PROVO, UT 84604-3374
(801) 374-9100
(801) 374-9117

Taxonomy

Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
3089384-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
30893841201001
BLUE CROSS
UT
01
638375
DMBA
UT
01
870656925SM1
EMIA
UT
Enumeration date
07/13/2005
Last updated
02/13/2014
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