Organization
ST MICHAEL INFECTIOUS DISEASE ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. STEPHEN SMITH MD (OWNER)
(973) 877-2586
Entity
Organization
Contact information
Practice address
265 DR MARTIN LUTHER KING JR BLVD, NEWARK, NJ 07102-2012
(973) 877-2586
Mailing address
PO BOX 36, ROSELAND, NJ 07068-0036
(201) 512-9494
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
MA060236
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8420301
—
NJ
Enumeration date
05/22/2006
Last updated
05/27/2009
Update your record
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