Healthcare Provider Details

I. General information

NPI: 1417207762
Provider Name (Legal Business Name): HARVEY E SMITH MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/13/2012
Last Update Date: 09/13/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 PARKER HILL AVE CONV 4
BOSTON MA
02120-2847
US

IV. Provider business mailing address

PO BOX 86
HINGHAM MA
02043-0086
US

V. Phone/Fax

Practice location:
  • Phone: 617-754-5744
  • Fax: 617-754-5740
Mailing address:
  • Phone: 781-749-9071
  • Fax: 781-749-2133

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207XS0117X
TaxonomyOrthopaedic Surgery of the Spine Physician
License Number245967
License Number StateMA

VIII. Authorized Official

Name: DR. HARVEY E SMITH
Title or Position: OWNER
Credential: M.D.
Phone: 617-754-5744