Smith, Denise M
Smith, Denise M is an individual health care provider with primary practice located at 1211 W State Blvd , Fort Wayne IN 46808-3103. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Smith, Denise M can be contacted via phone (260) 422-0010.Contact Information
Primary practice address
1211 W State Blvd
Fort Wayne IN 46808-3103
Phone: (260) 422-0010
Fax: (260) 422-2212
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 02001605 | Indiana |
Profile Details
| NPI number | 1912907445 |
|---|---|
| LBN Legal business name | Smith, Denise M |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 27th, 2005 |
| Last updated | Nov 2nd, 2021 - about 3 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 | 1912907445 | NPPES |
| Indiana | MEDICAID | 200023850 | |
| Indiana | Other | 080175244 |
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