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General NPI Number Information
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NPI Number | 1235907007
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Entity Type | Individual
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Provider Name | CYNTHIA SMITH BEISSER MD
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Gender | Female
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Dates
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Enumeration Date | 12/12/2023
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Last Update Date | 12/12/2023
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Provider Practice Location Address
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Address Line | 43585 ELIZABETH ST
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City | MOUNT CLEMENS
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State | MI
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Zip | 48043-1000
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Country | US
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Telephone | 586-469-5214
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Fax |
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Provider Business Mailing Address
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Address Line | 6033 WHITE OAK DR
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City | TOLEDO
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State | OH
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Zip | 43615-5745
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Country | US
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Telephone |
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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 | 207ZF0201X
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Taxonomy Name | Forensic Pathology Physician
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License Number | 35-061819
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License Number State | OH
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