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:
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Health care specialties

SpecialtyCodeLicense #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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790866044 NPPES
Other 272030 INTERNAL ID-MOTOR VEHICLE ID
MEDICAID 8269235 INTERNAL ID-MOTOR VEHICLE ID

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