Individual
MR. CHAD D SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAC
Contact information
Practice address
1316 MERCY DR, MUSKEGON, MI 49444-1891
(231) 739-9461
(231) 733-8131
Mailing address
370 N 120TH AVE, HOLLAND, MI 49424-2196
(616) 396-5855
(616) 396-5720
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
5601005752
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1770627051
—
MI
01
—
CS005752
BLUE CROSS BLUE SHIELD
MI
Enumeration date
02/19/2007
Last updated
02/10/2020
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