Healthcare Provider Details

I. General information

NPI: 1427026434
Provider Name (Legal Business Name): HANNELORE E SMITH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/08/2006
Last Update Date: 11/21/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6046 WHIPPLE AVE NW
NORTH CANTON OH
44720
US

IV. Provider business mailing address

6046 WHIPPLE AVENUE NW
NORTH CANTON OH
44720
US

V. Phone/Fax

Practice location:
  • Phone: 330-433-1200
  • Fax: 330-305-5047
Mailing address:
  • Phone: 330-433-1400
  • Fax: 330-305-5047

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35044071A
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35044071
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: