MEDICARE: SCOTT B 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
1	207R00000X	Internal Medicine Physician	35-051034	OH

Other Identifiers

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

General Provider Information

NPI Number	:	1568559441
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SCOTT B SMITH MD

Provider Business Mailing Address
First Line	:	9318 STATE ROUTE 14 FL 3
Second Line	:
City	:	STREETSBORO
State	:	OH
Zip	:	44241-5224
Country	:	US
Telephone Number	:	330-626-3111
Fax Number	:	330-422-0919

Provider Business Practice Location Address
First Line	:	9318 STATE ROUTE 14 FL 3
Second Line	:
City	:	STREETSBORO
State	:	OH
Zip	:	44241-5224
Country	:	US
Telephone Number	:	330-626-3111
Fax Number	:	330-422-0919

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

Provider Enumeration Date	:	10/10/2006
Last Update Date	:	11/20/2020

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Directions to “ SCOTT B SMITH MD” Practice Location

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