Individual
DR. MARK WILLIAM SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
14734 PARK AVE, CHARLEVOIX, MI 49720-1927
(231) 547-6554
(231) 547-1179
Mailing address
14734 PARK AVE, CHARLEVOIX, MI 49720-1927
(231) 547-6554
(231) 547-1179
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
4301076489
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8002922550
—
MI
Enumeration date
09/06/2006
Last updated
07/02/2014
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