Smith, Mary
Smith, Mary is an individual health care provider with primary practice located at 601 W 2Nd St , Bloomington IN 47403-2317. She recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as her primary health care specialty. Smith, Mary can be contacted via phone (812) 353-9515.Contact Information
Primary practice address
601 W 2Nd St
Bloomington IN 47403-2317
Phone: (812) 353-9515
Fax: (812) 353-9275
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Emergency Medicine | 207P00000X | 01031934A | Indiana |
Profile Details
| NPI number | 1154339919 |
|---|---|
| LBN Legal business name | Smith, Mary |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 4th, 2006 |
| Last updated | Dec 30th, 2014 - about 10 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 | 1154339919 | NPPES |
| Indiana | MEDICAID | 100342780 |
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