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Individual

DR. STEPHEN MARK SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MBBS (MD EQUIVALENT)

Contact information

Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-2736
Mailing address
3181 SW SAM JACKSON PARK RD, UHN-67, PORTLAND, OR 97239-3011

Taxonomy

Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
MD25483
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
287963
OR
05
8264327
WA
01
R143424
MEDICARE PROVIDER NUMBER
Enumeration date
09/20/2006
Last updated
05/16/2012
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