Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 170100000X | Medical Geneticist | ME62450 | FL |
NPI | 1558368670 |
---|---|
Provider Name | Dr. Douglas Randall Smih |
First Address | Delray Beach, FL 33445-3865 |
Second Address | Delray Beach, FL 33445-3865 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/07/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E64586 | (02) | FL |