Healthcare Provider Details

I. General information

NPI: 1568577195
Provider Name (Legal Business Name): MARTIN SMILEK DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1900 23RD ST
CUYAHOGA FALLS OH
44223-1404
US

IV. Provider business mailing address

291 CROWN RIDGE DR
CUYAHOGA FALLS OH
44223-2979
US

V. Phone/Fax

Practice location:
  • Phone: 330-971-7000
  • Fax:
Mailing address:
  • Phone: 330-971-7000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number34-006167
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: