Provider Demographics
NPI:1528375201
Name:SMERKA, MICHAEL (CP)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:
Last Name:SMERKA
Suffix:
Gender:M
Credentials:CP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8 MITCHELL RD
Mailing Address - Street 2:
Mailing Address - City:MARBLEHEAD
Mailing Address - State:MA
Mailing Address - Zip Code:01945-1130
Mailing Address - Country:US
Mailing Address - Phone:781-990-3052
Mailing Address - Fax:
Practice Address - Street 1:8 MITCHELL RD
Practice Address - Street 2:
Practice Address - City:MARBLEHEAD
Practice Address - State:MA
Practice Address - Zip Code:01945-1130
Practice Address - Country:US
Practice Address - Phone:781-990-3052
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-01
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MACP003533224P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist