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NPI Code Detail

MEDICARE: DR. DOUGLAS RANDALL SMIH MD

MEDICARE: DR. DOUGLAS RANDALL SMIH 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
1170100000XPh.D. Medical GeneticsME62450FL

General Provider Information

NPI Number : 1558368670
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS RANDALL SMIH MD
Provider Business Mailing Address
First Line : 4723 W ATLANTIC AVE
Second Line : STE 10
City : DELRAY BEACH
State : FL
Zip : 33445-3865
Country : US
Telephone Number : 561-819-0821
Fax Number : 561-819-0824
Provider Business Practice Location Address
First Line : 4723 W ATLANTIC AVE
Second Line : STE 10
City : DELRAY BEACH
State : FL
Zip : 33445-3865
Country : US
Telephone Number : 561-819-0821
Fax Number : 561-819-0824
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2005
Last Update Date : 07/21/2022

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