Individual
GALEN DAVID SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2112 E OHMER RD, MAYVILLE, MI 48744-9501
(989) 843-5135
(989) 843-5121
Mailing address
81 S RINGLE RD, FAIRGROVE, MI 48733-9525
(989) 843-5135
(989) 843-5121
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601003431
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
5601003431
STATE LICENCE
MI
Enumeration date
08/19/2006
Last updated
07/08/2007
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