Individual
DR. MICHEL E HANEN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D., M..S
Contact information
Practice address
4323 E LAKE ST, MINNEAPOLIS, MN 55406-2307
(612) 722-1003
(612) 721-6331
Mailing address
4323 E LAKE ST, MINNEAPOLIS, MN 55406-2307
(612) 722-1003
(612) 721-6336
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
LD1652000
MN
152WC0802X
Corneal and Contact Management Optometrist
LD1652000
MN
152WX0102X
Occupational Vision Optometrist
362
ND
152WX0102X
Occupational Vision Optometrist
LD1652000
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00621001
PREFERRED ONE
MN
01
—
06314HA
CLINIC BCBS
MN
01
—
0748240001
DURABLE GOODS DMERC
—
01
—
101856
UCARE
MN
01
—
19312
PIN HEALTH PARTNERS
MN
01
—
2115985
MEDICAL DISP
MN
01
—
2202001
MEDICA PRIMARY
MN
01
—
2202691
MODIRA UNITED HEALTH CARE
MN
05
—
333023100
—
MN
01
—
3M197HA
PROVIDER BCBS
MN
01
—
411459852017
BSBC OF WI
WI
01
—
5C003HA
BLUE PLUS
MN
Enumeration date
11/13/2006
Last updated
12/27/2013
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