MEDICARE: DR. AARON ROBERT SMITH M.D.

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	207P00000X	Emergency Medicine Physician	35-059298	OH
2	207P00000X	Emergency Medicine Physician	16442	SC

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1174617443
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. AARON ROBERT SMITH M.D.

Provider Business Mailing Address
First Line	:	1001 LAKESIDE AVE E
Second Line	:	#1200
City	:	CLEVELAND
State	:	OH
Zip	:	44114-1158
Country	:	US
Telephone Number	:	216-479-5541
Fax Number	:	216-479-5554

Provider Business Practice Location Address
First Line	:	2550 ELMS CENTER RD
Second Line	:
City	:	N CHARLESTON
State	:	SC
Zip	:	29406-9844
Country	:	US
Telephone Number	:	843-572-7727
Fax Number	:	843-569-5881

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

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	10/09/2014

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