Individual
JUSTIN MICHAEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
1925 PACIFIC AVE, ATLANTIC CITY, NJ 08401-6713
(609) 441-8127
Mailing address
1925 PACIFIC AVE # 8, ATLANTIC CITY, NJ 08401-6713
(609) 441-8127
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
25MB11208000
NJ
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/05/2018
Last updated
08/28/2021
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