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Individual

MARILYN P SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
401 MONROE TPKE, CANTERBURY PEDIATRICS, MONROE, CT 06468-2276
(203) 452-1063
Mailing address
12 CAMBRIDGE DR, CREDENTIALS XPRESS, TRUMBULL, CT 06611-4764

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
030831
CT

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
001308312
CT
01
010030831CT04
ANTHEM BC/BS
CT
01
2999672
AETNA
CT
01
2V2847
HEALTH NET
CT
01
308310
CONNECTICARE
CT
01
36-4505937
NEHCA HMC/PPO
CT
01
4398415006
CIGNA
CT
01
507Y41
EMPIRE BC/BS
CT
01
ZP164
OXFORD HEALTH PLANS
CT
Enumeration date
08/11/2006
Last updated
01/25/2011
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