Individual
MAXINE M SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD
Contact information
Practice address
9500 EUCLID AVE, CLEVELAND, OH 44195-0001
(800) 223-2273
Mailing address
7825 N GANNETT RD, SAGAMORE HILLS, OH 44067-2921
(330) 468-4062
(216) 445-4356
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD2726
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000393115
ANTHEM PIN
OH
01
—
124252
KAISER PIN
OH
01
—
7429813
AETMA PIN #
OH
01
—
7753436
AETNA GROUP PIN#
OH
Enumeration date
06/05/2006
Last updated
07/09/2007
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