Individual
DR. ALEXANDER KELIIMOEANU SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
55 FRUIT ST, FND 600, BOSTON, MA 02114-2696
(617) 724-9197
(617) 724-8693
Mailing address
PO BOX 9142, CHARLESTOWN, MA 02129-9142
(617) 724-0287
(617) 726-2894
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
223415
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2101068
—
MA
01
—
468156
TUFTS HEALTH PLAN
MA
01
—
J28582
BCBS MA
MA
Enumeration date
11/02/2005
Last updated
07/08/2007
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