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NPI Code Detail

MEDICARE: ANDREW DONALD SMITH JR. M.D.

MEDICARE: ANDREW DONALD SMITH JR. M.D.
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
12086S0102XSurgical Critical Care Physician29799MN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1144212572
Entity Type Code : Individual
Provider Name (Legal Business Name) : ANDREW DONALD SMITH JR. M.D.
Provider Business Mailing Address
First Line : 1000 1ST DR NW
Second Line :
City : AUSTIN
State : MN
Zip : 55912-2941
Country : US
Telephone Number : 507-433-8758
Fax Number :
Provider Business Practice Location Address
First Line : 1000 1ST DR NW
Second Line :
City : AUSTIN
State : MN
Zip : 55912-2941
Country : US
Telephone Number : 507-433-8758
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/22/2005
Last Update Date : 02/24/2012

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