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General NPI Number Information
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NPI Number | 1760825533
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Entity Type | Individual
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Provider Name | ANDREA R. SMITH M.D.
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Gender | Female
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Dates
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Enumeration Date | 04/11/2013
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Last Update Date | 04/02/2021
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Provider Practice Location Address
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Address Line | 500 W BROADWAY ST FL 4
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City | MISSOULA
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State | MT
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Zip | 59802
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Country | US
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Telephone | 406-327-1900
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Fax | 406-327-1974
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Provider Business Mailing Address
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Address Line | 500 W BROADWAY ST FL 4
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City | MISSOULA
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State | MT
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Zip | 59802-4008
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Country | US
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Telephone | 406-327-1900
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Fax | 406-327-1974
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 0101261098
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 67175
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License Number State | MT
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