Individual
DR. TERRY GLEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
67-1123 MAMALAHOA HWY, SUITE 120, KAMUELA, HI 96743-8451
(808) 885-5236
(808) 885-4126
Mailing address
PO BOX 2650, KAMUELA, HI 96743-2650
(808) 885-5236
(808) 885-4126
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
6367
HI
207XS0117X
Orthopaedic Surgery of the Spine Physician
6367
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
522260
—
HI
01
—
K07806-9
HMSA PROVIDER NUMBER
HI
Enumeration date
11/01/2006
Last updated
04/21/2009
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