Provider Demographics
NPI:1003994476
Name:SMITH, C CHRISTOPHER (MDFACS)
Entity Type:Individual
Prefix:DR
First Name:C
Middle Name:CHRISTOPHER
Last Name:SMITH
Suffix:
Gender:M
Credentials:MDFACS
Other - Prefix:
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Mailing Address - Street 1:43 WHITING HILL RD
Mailing Address - Street 2:SUITE 300
Mailing Address - City:BREWER
Mailing Address - State:ME
Mailing Address - Zip Code:04412-1005
Mailing Address - Country:US
Mailing Address - Phone:207-973-5000
Mailing Address - Fax:207-973-5042
Practice Address - Street 1:885 UNION ST
Practice Address - Street 2:SUITE 145
Practice Address - City:BANGOR
Practice Address - State:ME
Practice Address - Zip Code:04401-3083
Practice Address - Country:US
Practice Address - Phone:207-973-9595
Practice Address - Fax:207-973-7515
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2012-02-08
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Provider Licenses
StateLicense IDTaxonomies
NH8105207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHB65417Medicare UPIN
NHRE0022Medicare ID - Type Unspecified