Individual
SAMUEL M SMITH
Active
Individual
SAMUEL M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
051741
GA
207L00000X
Anesthesiology Physician
Primary
MD21745
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000587716A
—
GA
05
—
009601310
—
AL
01
—
0168146
BCBS
TN
01
—
050047704
RR MEDICARE
—
05
—
3061512
—
TN
05
—
5902182
—
NC
01
—
N374698
WELLCARE (GA MEDICAID)
GA
01
—
XXX-XX-9544
TRICARE
—
Enumeration date
11/16/2006
Last updated
01/14/2010
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