Smith, Stephen Robert
Smith, Stephen Robert is an individual health care provider with primary practice located at 1 Shaws Cv , New London CT 06320-4902. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Smith, Stephen Robert can be contacted via phone (860) 447-8304.Contact Information
Primary practice address
1 Shaws Cv
New London CT 06320-4902
Phone: (860) 447-8304
Fax: (860) 443-8720
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 5609 | Rhode Island |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 017278 | Connecticut |
Profile Details
| NPI number | 1396862686 |
|---|---|
| LBN Legal business name | Smith, Stephen Robert |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 23rd, 2007 |
| Last updated | Apr 24th, 2012 - about 13 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 | 1396862686 | NPPES |
| Connecticut | MEDICAID | 004236346 |
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