Individual
MRS. KEIRSTEN E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
145 4TH AVE NE, FAMILY PRACTICE/ SPORTS MEDICINE, GLADSTONE, MI 49837
(906) 428-3273
(906) 428-1881
Mailing address
145 4TH AVE NE, FAMILY PRACTICE/ SPORTS MEDICINE, GLADSTONE, MI 49837
(906) 428-3273
(906) 428-1881
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
4301116666
MI
207Q00000X
Family Medicine Physician
L4014R
AL
207Q00000X
Family Medicine Physician
MD36202
AL
207QS0010X
Sports Medicine (Family Medicine) Physician
Primary
430111666
MI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1679985311
—
MI
Enumeration date
05/29/2014
Last updated
02/04/2022
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