Individual
EDWARD B SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3289 N MAYFAIR RD, WAUWATOSA, WI 53222-3203
(414) 771-7900
(414) 607-6336
Mailing address
3289 N MAYFAIR RD, WAUWATOSA, WI 53222-3203
(414) 771-7900
(414) 607-6336
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
25439
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31706400
—
WI
01
—
P00465794
RR MEDICARE
WI
Enumeration date
07/10/2006
Last updated
11/23/2021
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