Individual
DR. MICHAEL J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2 TECHNOLOGY PARK DR, BOURNE, MA 02532-8341
(508) 743-9543
(508) 743-8335
Mailing address
139 SANDWICH ST, PLYMOUTH, MA 02360-2449
(508) 743-9543
(508) 743-8335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
223770
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02769928
—
NY
01
—
223770
STATE LICENSE
NY
Enumeration date
09/06/2005
Last updated
03/07/2023
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