Individual
MARY SMYTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3535 W 13 MILE RD STE LL, ROYAL OAK, MI 48073-6770
(248) 551-3000
Mailing address
26901 BEAUMONT BLVD STE 3D, SOUTHFIELD, MI 48033-3849
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
4301050699
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3031548
—
MI
01
—
350F361320
BCBSM
MI
Enumeration date
03/31/2006
Last updated
10/23/2020
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