Individual
NEIL P SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
20455 LORAIN RD, SUITE 104, FAIRVIEW PARK, OH 44126-3494
(440) 356-9844
(440) 356-0660
Mailing address
20455 LORAIN RD, SUITE 104, FAIRVIEW PARK, OH 44126-3494
(440) 356-9844
(440) 356-0660
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
34005125
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000136004
ANTHEM
OH
05
—
0808746
—
OH
01
—
289508377-00
BWC
OH
Enumeration date
09/01/2006
Last updated
04/21/2017
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