Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 31536 | MN |
NPI | 1033185343 |
---|---|
Provider Name | Dr. Cindy F Smith |
First Address | Willmar, MN 56201 |
Second Address | Willmar, MN 56201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E61041 | (02) |