Individual
RYAN D. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AA-C
Contact information
Practice address
13123 E 16TH AVE, AURORA, CO 80045-7106
(720) 777-1234
Mailing address
PO BOX 110429, AURORA, CO 80042-0429
(303) 493-7000
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
2013034524
MO
367H00000X
Anesthesiologist Assistant
Primary
ANT.0000055
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PENDING
—
MO
Enumeration date
09/17/2013
Last updated
04/19/2016
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