Individual
DR. CHARLES MITTNACHT SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1101 PADRE KINO, SANTA FE, NM 87501-2900
(505) 992-1101
(505) 992-1101
Mailing address
1101 PADRE KINO, SANTA FE, NM 87501-2900
(505) 992-1101
(505) 992-1101
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
C1-0000685
DE
207R00000X
Internal Medicine Physician
Primary
C1-0000685
DE
Other
Enumeration date
09/16/2012
Last updated
09/16/2012
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