Organization
MARK W SMITH MD PLC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARK WILLIAM SMITH MD (MANAGING MEMBER)
(231) 547-6510
Entity
Organization
Contact information
Practice address
14705 W UPRIGHT ST, CHARLEVOIX, MI 49720-1949
(231) 547-6510
(231) 547-7456
Mailing address
14705 W UPRIGHT ST, CHARLEVOIX, MI 49720-1949
(231) 547-6510
(231) 547-7456
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301076489
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
B002922530
—
MI
Enumeration date
06/03/2008
Last updated
01/21/2009
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