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General NPI Number Information
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NPI Number | 1932266251
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Entity Type | Organization
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Legal Business Name | SIDNEY J SMITH MD PC
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Dates
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Enumeration Date | 01/03/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 1086 N MONROE ST
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City | MONROE
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State | MI
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Zip | 48162-3193
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Country | US
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Telephone | 734-457-3340
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Fax | 734-457-3910
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Provider Business Mailing Address
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Address Line | 1086 N MONROE ST
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City | MONROE
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State | MI
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Zip | 48162-3193
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Country | US
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Telephone | 734-457-3340
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Fax | 734-457-3910
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Authorized Official
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Title or Position | OWNER
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Name | SIDNEY J. SMITH
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Credential | M.D.
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Telephone | 734-457-3340
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number |
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License Number State | OH
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