Individual
DR. EDWARD R. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
300 LONGWOOD AVE, BADER 3, BOSTON, MA 02115-5724
(617) 355-8414
(617) 730-0906
Mailing address
300 LONGWOOD AVE, BADER 3, BOSTON, MA 02115-5724
(617) 355-8414
(617) 730-0906
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
161140
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1010970
VT MEDICAID
VT
01
—
30203759
MEDICAID HEALTH KIDS
NH
01
—
3159607
AETNA
MA
01
—
710422
TUFTS HEALTH
MA
05
—
9757597
—
MA
01
—
AA8312
HARVARD PILGRIM HEALTH
MA
01
—
M14829
BCBS
MA
Enumeration date
01/26/2006
Last updated
04/17/2018
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