Individual
JUSTIN J SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
19895 DETROIT RD, ROCKY RIVER, OH 44116-1815
(440) 356-5500
(440) 356-0660
Mailing address
19895 DETROIT RD, ROCKY RIVER, OH 44116-1815
(440) 356-5500
(440) 356-0660
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
34006605
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000141846
ANTHEM
OH
05
—
2197073
—
OH
Enumeration date
09/01/2006
Last updated
10/28/2012
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