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Individual
THOMAS E SMITH
Active
Individual
THOMAS E SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E2504
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000E25040
—
CA
05
—
000E25041
—
CA
01
—
480002990
PALMETTO GBA
CA
01
—
480012426
PALMETTO GBA
CA
Enumeration date
07/12/2006
Last updated
05/13/2008
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