Individual
CLIFTON DELOS SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
905 MAIN ST, VASSALBORO, ME 04989-3107
(207) 873-6173
(207) 873-4514
Mailing address
PO BOX 247, NORTH VASSALBORO, ME 04962-0247
(207) 873-6173
(207) 873-4514
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
011712
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000927
ANTHEM
ME
01
—
1041270
AETNA HMO
—
01
—
110084669
RAILROAD MEDICARE
—
01
—
5201627
AETNA NON-HMO
—
01
—
D78788
HARVARD PILGRIM
—
Enumeration date
04/21/2006
Last updated
01/12/2011
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