Individual
MICHAEL W SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3000 COLISEUM DR, SENTARA CAREPLEX HOSPITAL, HAMPTON, VA 23666-5963
(757) 736-1621
(757) 827-6748
Mailing address
PO BOX 12127, TIDEWATER DIAGNOSTIC IMAGING, NEWPORT NEWS, VA 23612-2127
(757) 867-6101
(757) 867-6587
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
0101238465
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10005664
SENTARA
VA
01
—
P00316605
RAILROAD MEDICARE
VA
Enumeration date
12/21/2005
Last updated
07/08/2007
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