Individual
DR. CHARLES MELVIN SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2000 W BETHANY HOME RD, PHOENIX, AZ 85015-2443
(602) 249-0212
Mailing address
5501 E CAMELBACK RD, PHOENIX, AZ 85018-3112
(602) 952-1461
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
15726
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
260266
—
AZ
01
—
3981220
EYECARE
AZ
01
—
AW1436
HEALTHNET
AZ
01
—
AZ0728670
BLUE CROSS BLUE SHIELD
AZ
Enumeration date
11/02/2005
Last updated
07/08/2007
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