Provider Demographics
NPI:1316922784
Name:SMITH, ROBERT C (MD)
Entity type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:595 SHREWSBURY AVE
Mailing Address - Street 2:STE 103
Mailing Address - City:SHREWSBURY
Mailing Address - State:NJ
Mailing Address - Zip Code:07702-1851
Mailing Address - Country:US
Mailing Address - Phone:732-741-5923
Mailing Address - Fax:732-741-2759
Practice Address - Street 1:595 SHREWSBURY AVE
Practice Address - Street 2:STE 103
Practice Address - City:SHREWSBURY
Practice Address - State:NJ
Practice Address - Zip Code:07702
Practice Address - Country:US
Practice Address - Phone:732-741-5923
Practice Address - Fax:732-741-2759
Is Sole Proprietor?:No
Enumeration Date:2005-12-08
Last Update Date:2014-02-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
NJMA067639208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ7654308Medicaid
NJ1030071OtherAETNA HMO
NJ5464680OtherAETNA PPO
NJ58T911OtherBCBS OF NY
NJ1099888OtherGHI PPO
NJ340016046OtherRAILROAD MEDICARE
NJ0259549000OtherAMERIHEALTH
NJ011648AWRMedicare PIN
NJ1030071OtherAETNA HMO