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Individual

DR. STEPHEN LOWELL SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
39 LESSAY, NEWPORT COAST, CA 92657-1025
(904) 315-5505
Mailing address
39 LESSAY, NEWPORT COAST, CA 92657-1025
(904) 315-5505

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
G52278
CA
208600000X
Surgery Physician
ME61688
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
14611
BLUECROSS/BLUESHIELD
FL
01
266978
AVMED
FL
01
3646090
CIGNA
01
4043095
AETNA
FL
05
823712756A
GA
01
P00676831
RAILROAD MEDICARE
FL
Enumeration date
10/18/2005
Last updated
06/10/2022
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