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Individual

DR. PETER STANLEY SMYTHE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3170 W CENTRAL AVE, TOLEDO, OH 43606-2945
(419) 534-3500
(419) 534-2608
Mailing address
PO BOX 20452, COLUMBUS, OH 43220-0452
(614) 442-2406
(614) 442-2410

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
35057455
OH
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
4301053621
MI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000029112
ANTHEM-OH
OH
05
0743217
OH
01
220008700
RR - MCR
05
2644384
MI
01
461127
BCBS - MI
MI
Enumeration date
03/22/2006
Last updated
12/03/2013
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