Healthcare Provider Details

I. General information

NPI: 1487747283
Provider Name (Legal Business Name): ROBIN R WILSON-SMITH D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/02/2006
Last Update Date: 10/07/2025
Certification Date: 10/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 MEDICAL CENTER DR STE 205
SEWELL NJ
08080-2358
US

IV. Provider business mailing address

1 FEDERAL ST STE SW200
CAMDEN NJ
08103-1155
US

V. Phone/Fax

Practice location:
  • Phone: 856-557-5400
  • Fax: 856-557-5399
Mailing address:
  • Phone: 856-968-7433
  • Fax: 856-968-8366

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberMB076560
License Number StateNJ
# 2
Primary TaxonomyY
Taxonomy Code207VX0201X
TaxonomyGynecologic Oncology Physician
License NumberMB07656000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: