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NPI Code Detail

MEDICARE: DR. MICHAEL D SMITH M.D.

MEDICARE: DR. MICHAEL D SMITH M.D.
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
1207XS0117XOrthopaedic Surgery of the Spine Physician33162MN

General Provider Information

NPI Number : 1528032315
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MICHAEL D SMITH M.D.
Provider Business Mailing Address
First Line : 4200 DAHLBERG DR
Second Line : SUITE 300
City : GOLDEN VALLEY
State : MN
Zip : 55422-4840
Country : US
Telephone Number : 952-512-5600
Fax Number : 952-512-5651
Provider Business Practice Location Address
First Line : 4010 W 65TH ST
Second Line :
City : EDINA
State : MN
Zip : 55435-1706
Country : US
Telephone Number : 952-456-7000
Fax Number : 952-456-7001
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/16/2006
Last Update Date : 05/02/2017

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