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Individual

ERIC N SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
46 BARRA RD STE 103, BIDDEFORD, ME 04005-9461
(207) 283-1126
Mailing address
301C US ROUTE 1, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
PA1275
ME
363AS0400X
Surgical Physician Assistant
Primary
PA001275
ME

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1447547864
ME
Enumeration date
07/06/2011
Last updated
04/01/2019
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