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Individual

WILBUR SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4201 SAINT ANTOINE ST, UHC 3L8, DETROIT, MI 48201-2153
(313) 745-3430
(313) 577-8600
Mailing address
1560 E. MAPLE RD., SUITE 400-CREDENTIALING, TROY, MI 48083-1138
(248) 581-5974
(248) 581-5640

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
4301072516
MI
2085P0229X
Pediatric Radiology Physician
4301072516
MI
2085R0202X
Diagnostic Radiology Physician
Primary
4301072516
MI

Other

Enumeration date
08/07/2006
Last updated
12/10/2015
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