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NPI Code Detail

MEDICARE: DR. CAROLE J. SMITH MD

MEDICARE: DR. CAROLE J. SMITH MD
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
1207Q00000XFamily Medicine Physician220572MA
2207Q00000XFamily Medicine PhysicianMD15209RI
3207Q00000XFamily Medicine Physician282496NY
4207Q00000XFamily Medicine PhysicianMD20873ME

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1AA15512OTHERMAHARVARD PILGRIM
2469458OTHERMATUFTS HEALTH PLAN
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4J27786OTHERMABLUE CROSS BLUE SHIELD

General Provider Information

NPI Number : 1023087566
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CAROLE J. SMITH MD
Provider Business Mailing Address
First Line : 28 RIVERSIDE DR
Second Line :
City : PEMBROKE
State : MA
Zip : 02359-1937
Country : US
Telephone Number : 781-826-8065
Fax Number : 781-826-8043
Provider Business Practice Location Address
First Line : 28 RIVERSIDE DR
Second Line :
City : PEMBROKE
State : MA
Zip : 02359-1937
Country : US
Telephone Number : 781-826-8065
Fax Number : 781-826-8043
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2006
Last Update Date : 02/22/2016

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PEMBROKE, MA
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PEMBROKE, MA
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1225015167 — MICHELLE L. CONNORS PA
Practice Location Address:
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PEMBROKE, MA
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Practice Fax: 781-826-8043

Directions to “ DR. CAROLE J. SMITH MD” Practice Location

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