MEDICARE: DR. ROBERT D. SMINK JR. MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208600000X	Surgery Physician	MD012400E	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1003819079
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ROBERT D. SMINK JR. MD

Provider Business Mailing Address
First Line	:	100 E LANCASTER AVE
Second Line	:
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-3450
Country	:	US
Telephone Number	:	610-642-1908
Fax Number	:	610-642-6808

Provider Business Practice Location Address
First Line	:	100 E LANCASTER AVE
Second Line	:
City	:	WYNNEWOOD
State	:	PA
Zip	:	19096-3450
Country	:	US
Telephone Number	:	610-642-1908
Fax Number	:	610-642-6808

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/24/2005
Last Update Date	:	07/08/2007

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