Provider Demographics
NPI:1023550183
Name:SMART PHYSICIAN SYSTEMS PC
Entity Type:Organization
Organization Name:SMART PHYSICIAN SYSTEMS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:AUTHORIZED OFFICIAL
Authorized Official - Prefix:
Authorized Official - First Name:SYED
Authorized Official - Middle Name:R
Authorized Official - Last Name:MAJID
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:219-805-5333
Mailing Address - Street 1:10176 W 400 N STE C
Mailing Address - Street 2:
Mailing Address - City:MICHIGAN CITY
Mailing Address - State:IN
Mailing Address - Zip Code:46360-9009
Mailing Address - Country:US
Mailing Address - Phone:219-805-5333
Mailing Address - Fax:219-873-0001
Practice Address - Street 1:10176 W 400 N STE C
Practice Address - Street 2:
Practice Address - City:MICHIGAN CITY
Practice Address - State:IN
Practice Address - Zip Code:46360-9009
Practice Address - Country:US
Practice Address - Phone:219-805-5333
Practice Address - Fax:219-873-0001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-11-07
Last Update Date:2018-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty