Provider Demographics
NPI:1114422953
Name:SMUCKER, DARREN MICHAEL (MD)
Entity Type:Individual
Prefix:
First Name:DARREN
Middle Name:MICHAEL
Last Name:SMUCKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:65 COMMUNITY RD STE C
Mailing Address - Street 2:
Mailing Address - City:TALLMADGE
Mailing Address - State:OH
Mailing Address - Zip Code:44278-2358
Mailing Address - Country:US
Mailing Address - Phone:330-633-6601
Mailing Address - Fax:330-634-1329
Practice Address - Street 1:65 COMMUNITY RD STE C
Practice Address - Street 2:
Practice Address - City:TALLMADGE
Practice Address - State:OH
Practice Address - Zip Code:44278-2358
Practice Address - Country:US
Practice Address - Phone:330-633-6601
Practice Address - Fax:330-634-1329
Is Sole Proprietor?:Yes
Enumeration Date:2018-03-26
Last Update Date:2021-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35.141218207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty