Individual
JUSTIN R SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
35 MEDICAL CENTER PKWY, AUGUSTA, ME 04330-8160
(207) 626-1218
Mailing address
154 GARLAND RD, WINSLOW, ME 04901-0601
(207) 680-0915
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
184759
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
184759
CSFA
ME
Enumeration date
08/28/2018
Last updated
08/28/2018
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