Individual
DR. EDWARD JULIEN SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
2450 RIVERSIDE AVE, MINNEAPOLIS, MN 55454-1450
(612) 672-6000
Mailing address
1121 E NORTH AVE, MILWAUKEE, WI 53212-3515
(414) 267-6502
(414) 267-3892
Taxonomy
Speciality
Code
Description
License number
State
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
67687
MN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/06/2017
Last updated
08/10/2021
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