Provider Demographics
NPI:1497841464
Name:SMARTY, SYLVESTER (MD)
Entity Type:Individual
Prefix:
First Name:SYLVESTER
Middle Name:
Last Name:SMARTY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:SYLVESTER
Other - Middle Name:I
Other - Last Name:ONWUKA-SMARTY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:3505 E ROYALTON RD
Mailing Address - Street 2:SUITE 174
Mailing Address - City:BROADVIEW HEIGHTS
Mailing Address - State:OH
Mailing Address - Zip Code:44147-2994
Mailing Address - Country:US
Mailing Address - Phone:440-838-5536
Mailing Address - Fax:440-838-5537
Practice Address - Street 1:3505 E ROYALTON RD
Practice Address - Street 2:SUITE 174
Practice Address - City:BROADVIEW HEIGHTS
Practice Address - State:OH
Practice Address - Zip Code:44147-2994
Practice Address - Country:US
Practice Address - Phone:440-838-5536
Practice Address - Fax:440-838-5537
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2019-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLME1377752084P0800X
OH350826112084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH000000326906OtherANTHEM
OH4110184Medicare ID - Type Unspecified
OH4110183Medicare ID - Type Unspecified
OH4110185Medicare ID - Type Unspecified
OHH87642Medicare UPIN
OH4110182Medicare ID - Type Unspecified