Black-Smith, Kendra Mae
Black-Smith, Kendra Mae is an individual health care provider with primary practice located at 2003 Kootenai Health Way , Coeur D Alene ID 83814. She recently has only one registered license in Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine, which is considered as her primary health care specialty. Black-Smith, Kendra Mae can be contacted via phone (208) 625-5185.Contact Information
Primary practice address
2003 Kootenai Health Way
Coeur D Alene ID 83814
Phone: (208) 625-5185
Fax: (208) 625-6892
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | MD00039197 | Washington |
| Allopathic & Osteopathic Physicians / Neonatal-Perinatal Medicine | 2080N0001X | M14495 | Idaho |
Profile Details
| NPI number | 1790866044 |
|---|---|
| LBN Legal business name | Black-Smith, Kendra Mae |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 17th, 2006 |
| Last updated | Apr 3rd, 2019 - about 6 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790866044 | NPPES |
| Other | 272030 | INTERNAL ID-MOTOR VEHICLE ID | |
| MEDICAID | 8269235 | INTERNAL ID-MOTOR VEHICLE ID |
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