Individual
SAMUEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
610 30TH AVE W, ALEXANDRIA, MN 56308-3426
(320) 763-5123
Mailing address
610 30TH AVE W, ALEXANDRIA, MN 56308-3426
(320) 763-5123
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
71279
MN
Other
Enumeration date
06/03/2019
Last updated
10/21/2024
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