MEDICARE: ANDREW C 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
1	207R00000X	Internal Medicine Physician	35-04-3745	OH

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1841276490
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW C SMITH M.D.

Provider Business Mailing Address
First Line	:	6096 E MAIN ST STE 112
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-4302
Country	:	US
Telephone Number	:	614-755-3000
Fax Number	:	614-755-4052

Provider Business Practice Location Address
First Line	:	6096 E MAIN ST STE 112
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43213-4302
Country	:	US
Telephone Number	:	614-755-3000
Fax Number	:	614-755-4052

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/15/2005
Last Update Date	:	04/26/2017

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Directions to “ ANDREW C SMITH M.D.” Practice Location

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