Individual
STEPHEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1425 10TH AVE S, MINNEAPOLIS, MN 55404-1309
(612) 337-7410
Mailing address
701 PARK AVE, MINNEAPOLIS, MN 55415-1623
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
32437
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
769397400
—
MN
Enumeration date
06/16/2006
Last updated
07/30/2007
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