Individual
GEORGE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
UFP PHALEN VILLAGE CLINIC, 1414 MARYLAND AVE EAST, SAINT PAUL, MN 55106
(651) 772-3461
(651) 772-2605
Mailing address
UNIVERSITY OF MINNESOTA PHYSICIANS, 420 DELAWARE STREET SE, MINNEAPOLIS, MN 55455
(651) 772-3461
(651) 772-2605
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21092
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
01-01745
MEDICA PRIMARY
MN
01
—
1000658
PREFERRED ONE
MN
01
—
1027633
ARAZ
MN
01
—
108888
UCARE
MN
01
—
15F32SM
BLUE CROSS BLUE SHIELD
MN
01
—
HP17174
HEALTH PARTNERS
MN
Enumeration date
10/19/2006
Last updated
07/08/2007
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