Individual
DR. MICHAEL ELLSWORTH SMOTHERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3003 E LAKE DR S, ELKHART, IN 46514-4327
(574) 206-0465
(574) 262-5217
Mailing address
3003 E LAKE DR S, ELKHART, IN 46514-4327
(574) 206-0465
(574) 262-5217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
01042198
IN
207Q00000X
Family Medicine Physician
4301042611
MI
207QG0300X
Geriatric Medicine (Family Medicine) Physician
01042198
IN
Other
Enumeration date
05/28/2005
Last updated
07/20/2007
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