Provider Demographics
NPI:1003067240
Name:SMEDS, MATTHEW RUSSELL (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:RUSSELL
Last Name:SMEDS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1008 S SPRING AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63110-2520
Mailing Address - Country:US
Mailing Address - Phone:314-977-4730
Mailing Address - Fax:618-977-1642
Practice Address - Street 1:1225 S GRAND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63104-1016
Practice Address - Country:US
Practice Address - Phone:314-977-4730
Practice Address - Fax:314-977-1642
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-07
Last Update Date:2021-03-22
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Provider Licenses
StateLicense IDTaxonomies
MO20100119222086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery