MEDICARE: ENI 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	2083P0901X	Public Health & General Preventive Medicine Physician	4301500764	MI
2	2083A0300X	Addiction Medicine (Preventive Medicine) Physician	4301500764	MI
3	2083P0901X	Public Health & General Preventive Medicine Physician	62126	CT

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
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1659786275
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ENI SMITH M.D.

Provider Business Mailing Address
First Line	:	25235 ORCHARD LAKE RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-1233
Country	:	US
Telephone Number	:	248-466-4609
Fax Number	:

Provider Business Practice Location Address
First Line	:	25235 ORCHARD LAKE RD
Second Line	:
City	:	FARMINGTON HILLS
State	:	MI
Zip	:	48336-1233
Country	:	US
Telephone Number	:	248-466-4609
Fax Number	:

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

Provider Enumeration Date	:	06/23/2014
Last Update Date	:	03/30/2026

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