Organization
DAVID SMITH MD
Active
Organization subpart
No
Provider details
NPI number
Authorized official
VIKKI LAIDMAN CPC, CCS-P (BILLING MGR)
(518) 563-8290
Entity
Organization
Contact information
Practice address
9 ELM ST, PERU, NY 12972-2812
(518) 643-7037
(518) 643-2125
Mailing address
PO BOX 599, 9 ELM STREET, PERU, NY 12972-0599
(518) 643-7037
(518) 643-2125
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
190218
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01354865
—
NY
Enumeration date
09/04/2008
Last updated
09/04/2008
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