MEDICARE: DR. KRISTEN ALAINE SMITH 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
1	2084N0400X	Neurology Physician	57.011931	OH

General Provider Information

NPI Number	:	1346431632
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KRISTEN ALAINE SMITH M.D.

Provider Business Mailing Address
First Line	:	35040 CHARDON RD STE 110
Second Line	:
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44094-9004
Country	:	US
Telephone Number	:	440-946-1200
Fax Number	:	440-946-5186

Provider Business Practice Location Address
First Line	:	35040 CHARDON RD STE 110
Second Line	:
City	:	WILLOUGHBY HILLS
State	:	OH
Zip	:	44094-9004
Country	:	US
Telephone Number	:	440-946-1200
Fax Number	:	440-946-5186

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/05/2007
Last Update Date	:	05/12/2021

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