Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 4301098986 | MI |
Y | 207YP0228X | Pediatric Otolaryngology | 35.133129 | OH |
NPI | 1710272034 |
---|---|
Provider Name | Dr. Matthew Michael Smith |
First Address | Cincinnati, OH 45229-3026 |
Second Address | Cincinnati, OH 45229-3026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2011 |
Last Update Date | 28/03/2018 |