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General NPI Number Information
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NPI Number | 1740355940
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Entity Type | Organization
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Legal Business Name | EMILY D SMITH MD PLLC
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Dates
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Enumeration Date | 11/22/2006
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Last Update Date | 04/04/2008
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Provider Practice Location Address
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Address Line | 20905 GREENFIELD RD STE. 403
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City | SOUTHFIELD
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State | MI
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Zip | 48075-5360
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Country | US
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Telephone | 248-559-1911
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Fax | 248-559-1912
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Provider Business Mailing Address
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Address Line | 20905 GREENFIELD RD STE. 403
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City | SOUTHFIELD
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State | MI
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Zip | 48075-5360
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Country | US
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Telephone | 248-559-1911
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Fax | 248-559-1912
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Authorized Official
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Title or Position | OWNER
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Name | DR. EMILY D SMITH
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Credential | MD
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Telephone | 248-559-1911
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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 | 4301058103
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License Number State | MI
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