Individual
DR. ROBERT S. SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3715 MAIN ST, SUITE 306, BRIDGEPORT, CT 06606-3618
(203) 373-1775
Mailing address
3715 MAIN ST, SUITE 306, BRIDGEPORT, CT 06606-3618
(203) 373-1775
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
POO351
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004271631
AETNA ID#
CT
01
—
003935
HEALTHNET
CT
01
—
030000351CT03
BLUE CROSS PROVIDER #
CT
01
—
061364754
PRIVATE INSURANCE /TAX ID
CT
05
—
4078037
—
CT
01
—
4800009600
RAILROAD MEDICARE ID#
CT
01
—
6320755
CIGNA ID#
CT
Enumeration date
09/07/2005
Last updated
12/11/2007
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