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General NPI Number Information
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NPI Number | 1114308640
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Entity Type | Individual
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Provider Name | MICHELLE SMITH MD
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Gender | Female
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Dates
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Enumeration Date | 06/10/2015
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Last Update Date | 07/10/2025
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Provider Practice Location Address
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Address Line | 1835 WOODGROVE DR
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City | SPRINGBORO
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State | OH
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Zip | 45066-3501
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Country | US
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Telephone | 606-682-9433
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 933432
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City | CLEVELAND
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State | OH
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Zip | 44193-0039
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Country | US
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Telephone | 937-641-5072
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | 35.142296
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 11018335A
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License Number State | IN
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Taxonomy #3
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 50567
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License Number State | KY
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Taxonomy #4
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Taxonomy Code | 207ZP0102X
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Taxonomy Name | Anatomic Pathology & Clinical Pathology Physician
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License Number | 35.142296
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 207ZP0213X
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Taxonomy Name | Pediatric Pathology Physician
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License Number | 35.142296
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License Number State | OH
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