Individual
TODD ROBERT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3835 S FIRENZE WAY, MERIDIAN, ID 83642-1434
(801) 699-3892
Mailing address
3835 S FIRENZE WAY, MERIDIAN, ID 83642-1434
(801) 699-3892
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD419930
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12547911
CAQH
—
Enumeration date
10/06/2011
Last updated
07/29/2013
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