Individual
MR. CLARENCE MILTON SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1600 2ND AVE SW, MINOT, ND 58701-3459
(701) 858-1800
(701) 530-8842
Mailing address
900 E BROADWAY AVE, PO BOX 997, BISMARCK, ND 58502-0997
(701) 530-8833
(701) 530-8842
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3205
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
11730
—
ND
01
—
26755
BCBS
ND
01
—
31089
BCBS
ND
01
—
P00477682
RR MEDICARE
ND
Enumeration date
07/14/2006
Last updated
06/25/2010
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