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Individual

DR. EDWARD R. SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

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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