Smith, Corbett M

Smith, Corbett M is an individual health care provider with primary practice located at 2200 Randallia Dr , Fort Wayne IN 46805-4638. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Smith, Corbett M can be contacted via phone (260) 373-4000.

Contact Information

Primary practice address
2200 Randallia Dr Fort Wayne IN 46805-4638
Phone: (260) 373-4000
Fax: (260) 482-4442
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 01060047A Indiana

Profile Details

NPI number 1295720308
LBN Legal business name Smith, Corbett M
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 14th, 2005
Last updated May 10th, 2013 - about 11 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 1295720308 NPPES
Michigan MEDICAID 104874688
Michigan MEDICAID 200044400
Michigan Other 000000031001
Michigan Other 000000364860
Michigan MEDICAID 2589248

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