Individual
DR. JEFFREY D SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
4170 CEDAR BLUFF DR, PETOSKEY, MI 49770-7627
(231) 487-2230
(231) 487-6172
Mailing address
11149 SUMMERHILL WAY, CHARLEVOIX, MI 49720-9077
(978) 505-7006
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
204149
MA
208200000X
Plastic Surgery Physician
Primary
4301059444
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1144203175
—
MI
05
—
3208079
—
MA
Enumeration date
11/23/2005
Last updated
04/28/2021
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