Individual
DR. C. MICHAEL SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
28961 SAVANNAH DR, TEMECULA, CA 92591-7572
(386) 290-6479
Mailing address
303 N CLYDE MORRIS BLVD, DAYTONA BEACH, FL 32114-2709
(386) 254-4000
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
C140121
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
536809851A
—
GA
01
—
ME97255
MEDICAL LICENSE
FL
Enumeration date
12/29/2006
Last updated
07/21/2022
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