Individual
JOHN M SMYLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2601 HOLME AVE, PHILADELPHIA, PA 19152-2007
(215) 335-6144
Mailing address
1 W ELM ST, CONSHOHOCKEN, PA 19428-4108
(215) 830-9991
(215) 830-0375
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
MD029250E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0014681570003
—
PA
01
—
0448826
BLUE SHIELD
PA
01
—
058221000
INDEPENDECE BLUE CROSS
PA
Enumeration date
01/15/2007
Last updated
10/30/2017
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