Individual
DR. MICHAEL G SMOCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
621 S NEW BALLAS RD, SUITE 7003-B, SAINT LOUIS, MO 63141-8232
(314) 251-5570
(314) 251-5571
Mailing address
621 S NEW BALLAS RD, SUITE 7003-B, SAINT LOUIS, MO 63141-8232
(314) 251-5570
(314) 251-5571
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
119472
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1912976028
—
MO
01
—
P00265346
RAILROAD MEDICARE
MO
Enumeration date
03/14/2006
Last updated
12/19/2014
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