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Individual

DR. THOMAS G SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
33398 WALKER RD, SUITE C, AVON LAKE, OH 44012-1496
(440) 930-8630
(440) 930-8676
Mailing address
33398 WALKER RD, SUITE C, AVON LAKE, OH 44012-1496
(440) 930-8630
(440) 930-8676

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
35036379
OH
2080A0000X
Pediatric Adolescent Medicine Physician
35036379
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0322001
OH
Enumeration date
06/06/2006
Last updated
05/21/2008
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