Healthcare Provider Details

I. General information

NPI: 1467413500
Provider Name (Legal Business Name): SMITA HIMANSHU MAJMUDAR MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 03/29/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

30498 LAKESHORE BLVD
WILLOWICK OH
44095-4623
US

IV. Provider business mailing address

PO BOX 714110
COLUMBUS OH
43271-4110
US

V. Phone/Fax

Practice location:
  • Phone: 440-585-3322
  • Fax: 440-585-1962
Mailing address:
  • Phone: 440-716-1283
  • Fax: 440-716-1605

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number35-050257
License Number StateOH
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35-050257
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: