Provider Demographics
NPI:1689814154
Name:SMITH, MICHAEL OREN (CRNA)
Entity Type:Individual
Prefix:MR
First Name:MICHAEL
Middle Name:OREN
Last Name:SMITH
Suffix:
Gender:M
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 1817
Mailing Address - Street 2:LEXINGTON MEMORIAL HOSPITAL
Mailing Address - City:LEXINGTON
Mailing Address - State:NC
Mailing Address - Zip Code:27293-1817
Mailing Address - Country:US
Mailing Address - Phone:336-248-5161
Mailing Address - Fax:
Practice Address - Street 1:250 HOSPITAL DRIVES
Practice Address - Street 2:LEXINGTON MEMORIAL HOSPITAL
Practice Address - City:LEXINGTON
Practice Address - State:NC
Practice Address - Zip Code:27293-1817
Practice Address - Country:US
Practice Address - Phone:336-248-4530
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-02-24
Last Update Date:2009-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC099935163W00000X
NC038058367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No163W00000XNursing Service ProvidersRegistered Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC260673DMedicare UPIN