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Organization

CHERYL SMITH DO PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. CHERYL L SMITH D.O. (PRESIDENT)
(734) 759-0267
Entity
Organization

Contact information

Practice address
14700 KING RD, SUITE B, RIVERVIEW, MI 48193-7909
(734) 759-0267
(734) 759-0272
Mailing address
14700 KING RD, SUITE B, RIVERVIEW, MI 48193-7909
(734) 759-0267
(734) 759-0272

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
5101013898
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
080190734
MEDICARE RAILROAD
MI
01
080H234390
BCBSMI GROUP PIN
MI
01
0858208025
BCBSMI INDIVIDUAL PIN
MI
01
1073502928
INDIVIDUAL NPI
MI
05
114351229
MI
01
7160324
AETNA
MI
Enumeration date
05/10/2007
Last updated
12/16/2009
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