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General NPI Number Information
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NPI Number | 1639157365
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Entity Type | Individual
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Provider Name | RYAN MICHAEL SMITH DO, FACC
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Gender | Male
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Dates
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Enumeration Date | 01/03/2006
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Last Update Date | 04/24/2021
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Provider Practice Location Address
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Address Line | 46-001 KAMEHAMEHA HWY STE 212
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City | KANEOHE
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State | HI
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Zip | 96744-3728
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Country | US
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Telephone | 808-636-6393
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Fax | 866-573-0778
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Provider Business Mailing Address
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Address Line | 1 JARRETT WHITE ROAD DEPARTMENT OF MEDICINE
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City | HONOLULU
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State | HI
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Zip | 96859
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Country | US
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Telephone | 808-433-5119
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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 | 1156
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License Number State | HI
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