Individual
DOUGLAS BRUCE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
300 LAFAYETTE AVE SE STE 3000, GRAND RAPIDS, MI 49503-4692
(616) 685-6919
Mailing address
200 JEFFERSON AVE SE STE 305, GRAND RAPIDS, MI 49503-4502
(616) 685-4615
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
5151017119
MI
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
04/09/2024
Last updated
04/04/2025
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