MEDICARE: ROBERT MACLEAN SMITH MD

Medicare Provider Information

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

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RA0201X	Allergy & Immunology (Internal Medicine) Physician	2708	SD

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	030003144	OTHER	SD	RR MEDICARE

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0006934	OTHER	SD	BCBS
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	94159	OTHER	IA	BCBS
5	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
6	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
7	4436	OTHER	NE	BCBS

NPI Number	:	1538113337
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT MACLEAN SMITH MD

Provider Business Mailing Address
First Line	:	PO BOX 5126
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57117-5126
Country	:	US
Telephone Number	:	605-335-1952
Fax Number	:	605-373-9971

Provider Business Practice Location Address
First Line	:	4301 W 57TH ST STE 160
Second Line	:
City	:	SIOUX FALLS
State	:	SD
Zip	:	57108-2288
Country	:	US
Telephone Number	:	605-332-7000
Fax Number	:	605-332-5455

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

Provider Enumeration Date	:	05/19/2006
Last Update Date	:	06/15/2016

2500 E 52ND ST N , CIGNA MEDICARE SERVICES
SIOUX FALLS, SD
57104-7106

Practice Phone: 605-373-0100
Practice Fax: