Organization
MICHAEL J SMITH MD SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL J SMITH M.D. (DIRECTOR PRESIDENT)
(715) 830-9990
Entity
Organization
Contact information
Practice address
714 W HAMILTON AVE, EAU CLAIRE, WI 54701-6937
(715) 830-9990
(715) 830-9995
Mailing address
714 W HAMILTON AVE, EAU CLAIRE, WI 54701-6937
(715) 830-9990
(715) 830-9995
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
33571
WI
208000000X
Pediatrics Physician
33571
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
31849300
—
WI
Enumeration date
11/13/2006
Last updated
02/23/2009
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