Healthcare Provider Details

I. General information

NPI: 1205871035
Provider Name (Legal Business Name): MICHAEL WILLIAM SMITH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 E HAMPDEN AVE STE 410
ENGLEWOOD CO
80113-2760
US

IV. Provider business mailing address

701 E HAMPDEN AVE STE 410
ENGLEWOOD CO
80113-2760
US

V. Phone/Fax

Practice location:
  • Phone: 303-788-1312
  • Fax: 303-788-1967
Mailing address:
  • Phone: 303-788-1312
  • Fax: 303-788-1967

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number2010-00595
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number252911-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2010-00595
License Number StateNC
# 4
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number2008017232
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: