Individual
DR. DOUGLAS SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2720 FAIRVIEW AVE N STE 100, ROSEVILLE, MN 55113-1306
(651) 241-5290
(651) 241-5140
Mailing address
2720 FAIRVIEW AVE N STE 100, ROSEVILLE, MN 55113-1306
(651) 241-5290
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
MT202293
PA
2084N0402X
Neurology with Special Qualifications in Child Neurology Physician
Primary
60589
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/12/2010
Last updated
03/03/2022
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