Individual
MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1021 BANDANA BLVD E STE 100, SAINT PAUL, MN 55108
(651) 241-9700
Mailing address
2925 CHICAGO AVE, MINNEAPOLIS, MN 55407-1321
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
65782
MN
Other
Enumeration date
04/04/2016
Last updated
07/08/2019
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