Provider Demographics
NPI:1205036654
Name:SMITH, DONNA DEYOUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:DONNA
Middle Name:DEYOUNG
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3688 EATON GATE LN
Mailing Address - Street 2:
Mailing Address - City:AUBURN HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48326-3892
Mailing Address - Country:US
Mailing Address - Phone:248-853-6613
Mailing Address - Fax:
Practice Address - Street 1:3688 EATON GATE LN
Practice Address - Street 2:
Practice Address - City:AUBURN HILLS
Practice Address - State:MI
Practice Address - Zip Code:48326-3892
Practice Address - Country:US
Practice Address - Phone:248-853-6613
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301066696261QC1800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QC1800XAmbulatory Health Care FacilitiesClinic/CenterCorporate Health