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General NPI Number Information
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NPI Number | 1316980246
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Entity Type | Individual
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Provider Name | DAVID G SMITH M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/14/2006
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Last Update Date | 02/16/2015
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Provider Practice Location Address
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Address Line | 7515 FREDLE DR
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City | PAINESVILLE
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State | OH
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Zip | 44077-9406
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Country | US
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Telephone | 440-853-8208
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Fax | 216-370-3249
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Provider Business Mailing Address
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Address Line | 10570 STAFFORD RD
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City | CHAGRIN FALLS
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State | OH
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Zip | 44023-5242
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Country | US
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Telephone | 440-666-5152
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | 35064610S
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License Number State | OH
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