Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | $$$$$$$$$ | MI |
N | 208600000X | Surgeon | $$$$$$$$$ | MI |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 036123693 | IL |
NPI | 1003005315 |
---|---|
Provider Name | Dr. Adam Bryant Smith |
First Address | Traverse City, MI 49684-6941 |
Second Address | Traverse City, MI 49684-6941 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2007 |
Last Update Date | 22/07/2011 |