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General NPI Number Information
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NPI Number | 1245733484
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Entity Type | Individual
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Provider Name | CHRISTOPHER C SMITH CRNA
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Gender | Male
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Dates
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Enumeration Date | 03/14/2018
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Last Update Date | 07/25/2025
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Provider Practice Location Address
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Address Line | 6071 W OUTER DR
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City | DETROIT
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State | MI
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Zip | 48235-2624
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Country | US
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Telephone | 313-966-3300
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Fax |
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Provider Business Mailing Address
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Address Line | 2451 WESTWOOD DR
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City | ROCHESTER HILLS
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State | MI
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Zip | 48306-3173
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Country | US
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Telephone | 586-610-6500
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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 | 163WC0200X
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Taxonomy Name | Critical Care Medicine Registered Nurse
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License Number | 4704285628
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 367500000X
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Taxonomy Name | Certified Registered Nurse Anesthetist
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License Number | 4704285628
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License Number State | MI
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