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NPI Code Detail

MEDICARE: DR. CHARLES MELVIN SMITH MD

MEDICARE:  DR. CHARLES MELVIN SMITH  MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine Physician15726AZ

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
13981220OTHERAZEYECARE
2AW1436OTHERAZHEALTHNET
3AZ0728670OTHERAZBLUE CROSS BLUE SHIELD
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144211855
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES MELVIN SMITH MD
Provider Business Mailing Address
First Line : 5501 E CAMELBACK RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85018-3112
Country : US
Telephone Number : 602-952-1461
Fax Number :
Provider Business Practice Location Address
First Line : 2000 W BETHANY HOME RD
Second Line :
City : PHOENIX
State : AZ
Zip : 85015-2443
Country : US
Telephone Number : 602-249-0212
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/02/2005
Last Update Date : 07/08/2007

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Directions to “ DR. CHARLES MELVIN SMITH MD” Practice Location

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