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NPI Code Detail

MEDICARE: R MACLEAN SMITH

MEDICARE: R MACLEAN SMITH
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
1207RA0201XAllergy & Immunology (Internal Medicine) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
10006932OTHERSDBCBS GROUP
290741LAOTHERMNBCBS GROUP

General Provider Information

NPI Number : 1780601518
Entity Type Code : Organization
Provider Name (Legal Business Name) : R MACLEAN SMITH
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 : PROVIDER AND OWNER
Name : ROBERT MACLEAN SMITH
Credential : MD
Telephone Number : 605-332-7000
Provider Enumeration Date : 07/16/2006
Last Update Date : 06/15/2016

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Directions to “R MACLEAN SMITH ” Practice Location

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