Individual
ROBERT NELSON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
3419
IA
207RN0300X
Nephrology Physician
Primary
3419
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1891746350
WELLMARK BCBS
HI
05
—
1891746350
—
IA
01
—
P00329646
RAILROAD MEDICARE
IA
Enumeration date
05/12/2006
Last updated
01/06/2015
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