Individual
DR. STEPHEN MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
11 N LOCUST ST, BUCKHANNON, WV 26201-2231
(304) 472-1600
(304) 472-6055
Mailing address
PO BOX 2630, CENTRAL WV MEDCORP INC, ELKINS, WV 26241-2630
(304) 637-3799
(304) 637-3369
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11623
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000159893
INDIVIDUAL BCBS NUMBER
WV
05
—
0083382000
—
WV
01
—
11623
MEDICAL LICENSE NUMBER
WV
01
—
WV11623B
HEALTH PLAN
WV
Enumeration date
08/10/2006
Last updated
08/24/2011
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