Provider Demographics
NPI:1013918861
Name:SMITH, ROBIN A (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBIN
Middle Name:A
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 THORNTON RD
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01890-3446
Mailing Address - Country:US
Mailing Address - Phone:781-820-6305
Mailing Address - Fax:
Practice Address - Street 1:107 WOBURN ST
Practice Address - Street 2:
Practice Address - City:READING
Practice Address - State:MA
Practice Address - Zip Code:01867-2907
Practice Address - Country:US
Practice Address - Phone:781-944-4250
Practice Address - Fax:781-944-6895
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2023-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA73693208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA3139883Medicaid
MAGX2683Medicare ID - Type Unspecified
MA3139883Medicaid