Provider Demographics
NPI:1679566442
Name:SMITH, ROBERT LEWIS (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:LEWIS
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1869
Mailing Address - Street 2:
Mailing Address - City:FLETCHER
Mailing Address - State:NC
Mailing Address - Zip Code:28732-1869
Mailing Address - Country:US
Mailing Address - Phone:828-687-5616
Mailing Address - Fax:828-650-8076
Practice Address - Street 1:127 VANCE HILL DR
Practice Address - Street 2:
Practice Address - City:MILLS RIVER
Practice Address - State:NC
Practice Address - Zip Code:28759-4996
Practice Address - Country:US
Practice Address - Phone:828-890-3883
Practice Address - Fax:828-890-3100
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC98-00701207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC891148KMedicaid
NC080147598OtherMEDICARE RR
NC1148KOtherBCBS NC
NC891148KMedicaid
NC1148KOtherBCBS NC