Provider Demographics
NPI:1346485505
Name:SMITH, ANN TIMMERMANN (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:TIMMERMANN
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 1:7835 TRUESDALE LANE
Mailing Address - Street 2:
Mailing Address - City:TRAVERSE CITY
Mailing Address - State:MI
Mailing Address - Zip Code:49686-1667
Mailing Address - Country:US
Mailing Address - Phone:231-631-0411
Mailing Address - Fax:
Practice Address - Street 1:7835 TRUESDALE LANE
Practice Address - Street 2:
Practice Address - City:TRAVERSE CITY
Practice Address - State:MI
Practice Address - Zip Code:49686-1667
Practice Address - Country:US
Practice Address - Phone:231-631-0411
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-02
Last Update Date:2008-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4301055435208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics