Individual
DR. ERIC ROBERT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
333 N 1ST ST STE 250, BOISE, ID 83702-6132
(208) 381-9384
Mailing address
190 E BANNOCK ST, BOISE, ID 83712-6241
(208) 381-8866
Taxonomy
Speciality
Code
Description
License number
State
2085N0700X
Neuroradiology Physician
A167502
CA
2085N0700X
Neuroradiology Physician
Primary
M-17109
ID
2085R0202X
Diagnostic Radiology Physician
67899-20
WI
390200000X
Student in an Organized Health Care Education/Training Program
4301107050
MI
Other
Enumeration date
07/07/2015
Last updated
03/09/2023
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