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NPI Code Detail

MEDICARE: MICHAEL PATRICK SMITH MPAS, PA-C

MEDICARE: MICHAEL PATRICK SMITH MPAS, PA-C
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
1363AM0700XMedical Physician Assistant022930NY

General Provider Information

NPI Number : 1417939265
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL PATRICK SMITH MPAS, PA-C
Provider Business Mailing Address
First Line : 908 NIAGARA FALLS BLVD STE 208
Second Line :
City : NORTH TONAWANDA
State : NY
Zip : 14120-2019
Country : US
Telephone Number : 716-692-3302
Fax Number : 716-692-4342
Provider Business Practice Location Address
First Line : 462 GRIDER ST
Second Line :
City : BUFFALO
State : NY
Zip : 14215-3098
Country : US
Telephone Number : 716-898-5001
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/17/2005
Last Update Date : 01/23/2019

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Directions to “ MICHAEL PATRICK SMITH MPAS, PA-C” Practice Location

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