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Individual

DAVID J SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1035 CHARLEVOIX DR, SUITE 100, GRAND LEDGE, MI 48837-2223
(517) 627-2181
(517) 622-1242
Mailing address
1035 CHARLEVOIX DR, SUITE 100, GRAND LEDGE, MI 48837-2223
(517) 627-2181
(517) 622-1242

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301030055
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080079682
MEDICARE RAILROAD
01
P54028
BLUE CARE NETWORK
MI
Enumeration date
10/13/2006
Last updated
10/01/2013
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