Physician Compare National (NPI:1417920463)

HEALTHCARE PROVIDER: ANDRE' BLAIR SMITH MD

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1417920463
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	6608905609
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20100601000639
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	SMITH
	Individual professional last name
Provider First Name	ANDRE
	Individual professional first name
Provider Middle Name	BLAIR
	Individual professional middle name
Provider Gender	M
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	MICHIGAN STATE UNIVERSITY COLLEGE OF HUMAN MEDICINE
	Individual professional's medical school
Graduation Year	1990
	Individual professional's medical school graduation year
Primary Specialty	FAMILY MEDICINE
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	6429 EARLINGTON LN
	Group Practice or individual's line 1 address
Line 2 Street Address	INGHAM REGIONAL ASSISTED LIVING
	Group Practice or individual's line 2 address
City	LANSING
	Group Practice or individual's city
State	MI
	Group Practice or individual's state
Zip Code	489178279
	Group Practice or individual's zip code (9 digits when available)

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	230230
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	EDWARD W SPARROW HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	230092
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HENRY FORD ALLEGIANCE HEALTH
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	230217
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	OAKLAWN HOSPITAL
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	231324
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	EATON RAPIDS MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Hospital Affiliation CCN 5	230005
	Medicare CCN of hospital where individual professional provides service 5
Hospital Affiliation LBN 5	EMMA L BIXBY MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 5
Professional Accepts Medicare Assignment	Y

Physician Compare National (NPI:1417920463)

HEALTHCARE PROVIDER: ANDRE' BLAIR SMITH MD

Individual Professional Information

Medical School Information

Practice Information

Hospital(s) Affiliation Information