Individual
DR. MARK L. SMUCKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1855 S MAIN ST STE A, GOSHEN, IN 46526-4845
(574) 533-7476
(574) 533-7145
Mailing address
1855 S MAIN ST STE A, GOSHEN, IN 46526-4845
(574) 533-7476
(574) 533-7145
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
01036688A
IN
207RI0011X
Interventional Cardiology Physician
01036688A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100327940
—
IN
Enumeration date
06/13/2005
Last updated
02/05/2014
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