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NPI Code Detail

MEDICARE: MICHAEL C SMITH CRNA

MEDICARE: MICHAEL C SMITH CRNA
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
1367500000XCertified Registered Nurse Anesthetist496147NY
2367500000XCertified Registered Nurse AnesthetistRN207879LPA

General Provider Information

NPI Number : 1871560888
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHAEL C SMITH CRNA
Provider Business Mailing Address
First Line : 1 GUTHRIE SQ
Second Line :
City : SAYRE
State : PA
Zip : 18840-1625
Country : US
Telephone Number : 570-888-5858
Fax Number : 570-882-3007
Provider Business Practice Location Address
First Line : 32-36 CENTRAL AVE
Second Line :
City : WELLSBORO
State : PA
Zip : 16901-1840
Country : US
Telephone Number : 570-326-8622
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/08/2006
Last Update Date : 03/17/2018

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Directions to “ MICHAEL C SMITH CRNA” Practice Location

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