Provider Demographics
NPI:1710926571
Name:SMITH, MARTIN PAUL (MD)
Entity Type:Individual
Prefix:
First Name:MARTIN
Middle Name:PAUL
Last Name:SMITH
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Gender:M
Credentials:MD
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Mailing Address - Street 1:20 CHAPEL ST
Mailing Address - Street 2:APT BG09
Mailing Address - City:BROOKLINE
Mailing Address - State:MA
Mailing Address - Zip Code:02446-7458
Mailing Address - Country:US
Mailing Address - Phone:206-200-7119
Mailing Address - Fax:
Practice Address - Street 1:330 BROOKLINE AVE
Practice Address - Street 2:SHAPIRO E-CC 4, RADIOLOGY
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02215-5400
Practice Address - Country:US
Practice Address - Phone:617-667-2521
Practice Address - Fax:617-667-2531
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-06
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
MA2243662085B0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085B0100XAllopathic & Osteopathic PhysiciansRadiologyBody Imaging