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General NPI Number Information
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NPI Number | 1881041556
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Entity Type | Individual
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Provider Name | MALCOLM CREIGHTON-SMITH MD
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Gender | Male
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Dates
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Enumeration Date | 05/23/2016
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Last Update Date | 03/31/2025
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Provider Practice Location Address
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Address Line | 1601 CONGRESS ST
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City | PORTLAND
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State | ME
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Zip | 04102-2102
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Country | US
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Telephone | 207-661-0100
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Fax | 207-661-8866
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Provider Business Mailing Address
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Address Line | 1601 CONGRESS ST
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City | PORTLAND
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State | ME
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Zip | 04102-2102
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Country | US
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Telephone | 207-661-0100
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Fax | 207-661-8866
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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 | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | 1881041556
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | MD24924
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License Number State | ME
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