Individual
ELIJAH T SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
727 W BURNSIDE ST, PORTLAND, OR 97209-3514
(503) 228-4533
Mailing address
727 W BURNSIDE ST, PORTLAND, OR 97209-3514
(503) 228-4533
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD167228
OR
Other
Enumeration date
04/07/2011
Last updated
06/23/2014
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