Individual
JENNIFER KRISTA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
35000 FORD RD, SUITE 3, WESTLAND, MI 48185-3719
(734) 721-4700
(734) 721-9186
Mailing address
35000 FORD RD, SUITE 3, WESTLAND, MI 48185-3719
(734) 721-4700
(734) 721-9186
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
5101014655
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300207909
TAX ID
MI
05
—
4758526
—
MI
Enumeration date
08/11/2005
Last updated
05/06/2008
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