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Individual

DR. ANDREW GERALD SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
100 MARIO CAPECCHI DR, SALT LAKE CITY, UT 84113-1103
(801) 662-3673
(801) 662-3664
Mailing address
PO BOX 413021, DEPARTMENT OF PEDIATRICS - INPATIENT MEDICINE, SALT LAKE CITY, UT 84141-3021
(801) 213-3900
(801) 585-3655

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
TL3586
ID
208000000X
Pediatrics Physician
5412561-1205
UT
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
5412561-1205
UT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
807219800
ID
Enumeration date
08/11/2005
Last updated
12/12/2024
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