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Individual
DR. PAUL J SMELTER
Active
Individual
DR. PAUL J SMELTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
036057595
IL
207Q00000X
Family Medicine Physician
Primary
P5004
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020057300
BLACK LUNG
IL
01
—
036057595
IL STATE LICENSE
IL
05
—
036057595
—
IL
01
—
08421024
BC/BS
IL
01
—
101738
HEALTHLINK
IL
01
—
103476
HEALTH ALLIANCE
IL
01
—
133586700
ACS-OWCP
IL
01
—
14D0435769
CLIA
IL
01
—
232889
PERSONAL CARE
IL
01
—
6394P
CATERPILLAR
IL
01
—
CD7143
RR MEDICARE GROUP
IL
01
—
P00194441
RR MEDICARE PIN
IL
01
—
P5004
MEDICAL LICENSE
TX
Enumeration date
08/09/2006
Last updated
05/19/2014
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