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NPI Code Detail

MEDICARE: DR. DAVID IRWIN SMITH M.D.

MEDICARE: DR. DAVID IRWIN 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
1208000000XPediatrics Physician103348-1NY

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1000922391002OTHERNYHEALTHNOW BCBSWNY
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
35989093OTHERNMAETNA HMO/PPO/POS
41290855OTHERNYINDEPENDENT HEALTH
5100573DLOTHERNYPREFERRED CARE

General Provider Information

NPI Number : 1568406015
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID IRWIN SMITH M.D.
Provider Business Mailing Address
First Line : 300 WEST AVE
Second Line :
City : BROCKPORT
State : NY
Zip : 14420-1118
Country : US
Telephone Number : 585-637-3905
Fax Number : 585-637-4990
Provider Business Practice Location Address
First Line : 300 WEST AVE
Second Line :
City : BROCKPORT
State : NY
Zip : 14420-1118
Country : US
Telephone Number : 585-637-3905
Fax Number : 585-637-4990
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/15/2006
Last Update Date : 07/08/2007

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