Doctor Name: | DR. ROBERT CHARLES SMALTZ |
NPI Number: | 1700883394 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 2001-312 |
Business Practice Address: | 2539 Medical Dr. Complex A, Ste. 103 Alamogordo, NM - 883102539 |
Business Phone Number: | 5054374909 |
Business Fax Number: | 5054374953 |
Mailing Address: | 2539 Medical Drive Complex A, Ste. 103, ALAMOGORDO |
State: | NM |
Postal Code: | 883102539 |
Phone Number: | 5054374909 |
Fax Number: | 5054374953 |
NPI Enumeration Date: | 06/28/2005 |
NPI Last Update Date: | 10/09/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | 03/17/2006 |
NPI Reactivation Date: | 03/23/2006 |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | 2001-312 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NM |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |