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General NPI Number Information
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NPI Number | 1881708477
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Entity Type | Organization
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Legal Business Name | ELIZABETH C SMITH MD PC
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Dates
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Enumeration Date | 08/19/2006
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Last Update Date | 12/20/2010
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Provider Practice Location Address
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Address Line | 5777 W MAPLE RD SUITE 170
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-2267
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Country | US
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Telephone | 248-855-0077
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Fax | 248-855-0042
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Provider Business Mailing Address
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Address Line | 5777 W MAPLE RD SUITE 170
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City | WEST BLOOMFIELD
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State | MI
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Zip | 48322-2267
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Country | US
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Telephone | 248-855-0077
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Fax | 248-855-0042
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Authorized Official
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Title or Position | OWNER
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Name | MS. ELIZABETH CATHERINE SMITH
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Credential | MD
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Telephone | 248-855-0077
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 4301067487
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License Number State | MI
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