Individual
RICHARD SMITH
Active
Individual
RICHARD SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
5101007087
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
100003491
RR MEDICARE
MI
05
—
1742175
—
MI
Enumeration date
12/22/2005
Last updated
01/05/2010
Update your record
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