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Individual

DR. MICHAEL G SMOCK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D

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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