Individual
CYNTHIA JANE SMITH
Active
Individual
CYNTHIA JANE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
30880
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0406173
MEDICA
MN
05
—
134500100
—
MN
01
—
1954423
AMERICAS PPO/ARAZ
MN
01
—
55435A002
TRICARE
MN
01
—
70G91BA
BLUE CROSS BLUE SHIELD MN
MN
01
—
NA3181040233
PREFERRED ONE
MN
01
—
P00059643
RAILROAD MEDICARE
MN
Enumeration date
08/16/2005
Last updated
03/11/2021
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