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NPI 1093100869

NPI 1093100869 : ANDREW HART SMITH MD : SHELTON, CT

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General NPI Number Information
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    NPI Number           |    1093100869
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    Entity Type          |    Individual 
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    Provider Name        |    ANDREW HART SMITH MD
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    03/30/2015
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    Last Update Date     |    09/25/2024
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Provider Practice Location Address
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    Address Line         |    100 BEARD SAWMILL RD STE 250 
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    City                 |    SHELTON
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    State                |    CT
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    Zip                  |    06484-6178
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    Country              |    US
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    Telephone            |    203-922-7870
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    Fax                  |    203-922-7872
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Provider Business Mailing Address
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    Address Line         |    100 BEARD SAWMILL RD STE 250 
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    City                 |    SHELTON
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    State                |    CT
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    Zip                  |    06484-6178
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    Country              |    US
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    Telephone            |    203-922-7870
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    Fax                  |    203-922-7872
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Authorized Official
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    Title or Position    |    
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    Name                 |        
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    Credential           |    
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    Telephone            |    
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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    Taxonomy Code        |    2086S0129X
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    Taxonomy Name        |    Vascular Surgery Physician
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    License Number       |    72193
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    License Number State |    CT
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