Individual
DAVID IAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
516 15TH AVE SE STE 190E, MINNEAPOLIS, MN 55455-0130
(612) 626-4789
Mailing address
516 15TH AVE SE SUITE 190E, MINNEAPOLIS, MN 55455-0130
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
59986
MN
Other
Enumeration date
05/10/2011
Last updated
06/13/2017
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