Individual
MATTHEW J SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1753 W RIDGEWAY AVE STE 103A, WATERLOO, IA 50701-4521
(319) 235-3568
(319) 235-5013
Mailing address
PO BOX 2818, WATERLOO, IA 50704-2818
(319) 235-3568
(319) 235-5013
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34208
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5212415
—
IA
Enumeration date
07/21/2005
Last updated
05/14/2020
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