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Individual

DR. PETER SMITH

Active
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Individual

DR. PETER SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.P.M.

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
N004433
NY
213ES0000X
Sports Medicine Podiatrist
PD1905
MA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
01895183
NY
01
10259
VYTRA
NY
01
6364966004
CIGNA
NY
01
NYB002451
SUBMITTER ID
NY
01
P1911509
OXFORD
NY
01
PO 44330
WORKERS COMPENSATION
NY
Enumeration date
01/25/2006
Last updated
02/12/2008
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