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General NPI Number Information
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NPI Number | 1245261817
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Entity Type | Organization
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Legal Business Name | SMITH INTERNAL MEDICINE GROUP LTD
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 100 HIGHLAND AVE SUITE 203
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City | PROVIDENCE
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State | RI
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Zip | 02906-2740
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Country | US
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Telephone | 401-521-2002
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Fax | 401-521-0906
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Provider Business Mailing Address
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Address Line | 100 HIGHLAND AVE SUITE 203
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City | PROVIDENCE
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State | RI
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Zip | 02906-2740
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Country | US
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Telephone | 401-521-2002
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Fax | 401-521-0906
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Authorized Official
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Title or Position | PRESIDENT CEO
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Name | DR. JEAN F SMITH
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Credential | MD
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Telephone | 401-521-2002
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State |
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