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Individual

JAMES M SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3701 12TH ST N, SUITE 100, ST CLOUD, MN 56303
(320) 253-7257
(320) 251-2938
Mailing address
3701 12TH ST N, SUITE 100, ST CLOUD, MN 56303
(320) 253-7257
(320) 251-2938

Taxonomy

Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
22038
MN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
111041
UCARE
01
1324439
MEDICA
01
532001
P-ONE
01
56657SM
BCBS
Enumeration date
07/18/2006
Last updated
07/08/2007
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