Individual
ANN C SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
18697 BAGLEY RD, CLEVELAND, OH 44130-3417
(440) 816-8000
Mailing address
7140 CRESTWAY RD, CLAYTON, OH 45315-9722
(330) 472-4245
(440) 879-0084
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50-001465
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000346911
ANTHEM
OH
01
—
P00215204
RAILROAD MEDICARE
OH
Enumeration date
12/22/2005
Last updated
08/17/2009
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