Healthcare Provider Details

I. General information

NPI: 1578905956
Provider Name (Legal Business Name): DONALD SMITH, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2013
Last Update Date: 07/30/2024
Certification Date: 07/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1101 W UNIVERSITY DR
ROCHESTER MI
48307-1863
US

IV. Provider business mailing address

1905 N HAMMOND LAKE DR
BLOOMFIELD HILLS MI
48302-0139
US

V. Phone/Fax

Practice location:
  • Phone: 248-652-5454
  • Fax: 248-601-6198
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207PE0005X
TaxonomyUndersea and Hyperbaric Medicine (Emergency Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. DONALD B SMITH JR.
Title or Position: OWNER
Credential: MD
Phone: 248-652-5454