Individual
DR. MARK EDWARD SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
237 RADIO DR STE 210, WOODBURY, MN 55125-4478
(612) 871-1145
(612) 870-5491
Mailing address
PO BOX 14909, MINNEAPOLIS, MN 55414-0909
(612) 871-1145
(612) 870-5491
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
512
NE
207RG0100X
Gastroenterology Physician
Primary
63619
MN
Other
Enumeration date
03/19/2008
Last updated
10/22/2018
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