Individual
MAXIMILIAN JAMES SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
41 MALL ROAD, LAHEY HOSPITAL & MEDICAL CENTER, BURLINGTON, MA 01805-0001
(781) 744-8170
(781) 744-5232
Mailing address
41 MALL ROAD, LAHEY HOSPITAL & MEDICAL CENTER, BURLINGTON, MA 01805-0001
(781) 744-8170
(781) 744-5232
Taxonomy
Speciality
Code
Description
License number
State
2085D0003X
Diagnostic Neuroimaging (Radiology) Physician
266093
MA
2085N0700X
Neuroradiology Physician
Primary
266093
MA
2085R0202X
Diagnostic Radiology Physician
266093
MA
2085R0202X
Diagnostic Radiology Physician
57898
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
111257095
MEDICARE PIN
KS
05
—
16317513
—
CO
01
—
559221YQ33
MEDICARE PIN
CO
01
—
559221YQN9
MEDICARE PIN
CO
01
—
559221YQPG
MEDICARE PIN
CO
01
—
559221ZLJ3
MEDICARE PIN
CO
01
—
H109845
MEDICARE PIN
HI
01
—
H109846
MEDICARE PIN
HI
01
—
H109847
MEDICARE PIN
HI
01
—
KA3249086
MEDICARE PIN
KS
01
—
NA1214108
MEDICARE PIN
NE
01
—
NA1215109
MEDICARE PIN
NE
01
—
NA2517086
MEDICARE PIN
NE
Enumeration date
04/05/2011
Last updated
06/26/2018
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