Individual
BENTE E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226
(414) 955-1450
(414) 955-0197
Mailing address
9200 W WISCONSIN AVE, MILWAUKEE, WI 53226-3522
(414) 955-1450
(414) 955-0197
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3152
WI
363A00000X
Physician Assistant
50004051
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0110128
—
OH
05
—
1851732457
—
WI
Enumeration date
07/11/2013
Last updated
07/24/2018
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