Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | MD034676E | PA |
N | 207RI0011X | Interventional Cardiology | MD034676E | PA |
NPI | 1083608947 |
---|---|
Provider Name | Dr. Gregory T Smith |
First Address | Pittsburgh, PA 15212-4740 |
Second Address | Pittsburgh, PA 15212-4740 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/09/2005 |
Last Update Date | 25/04/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0012280070003 | (05) | PA |
610908E15 | MEDICARE (01) | PA |
E55669 | (02) | PA |