Provider Demographics
NPI:1740229731
Name:SMITH, HARRY W (MD)
Entity Type:Individual
Prefix:
First Name:HARRY
Middle Name:W
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 WILLSON RD
Mailing Address - Street 2:
Mailing Address - City:PRINCETON
Mailing Address - State:MA
Mailing Address - Zip Code:01541-1114
Mailing Address - Country:US
Mailing Address - Phone:978-464-0420
Mailing Address - Fax:
Practice Address - Street 1:16 WILLSON RD
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:MA
Practice Address - Zip Code:01541-1114
Practice Address - Country:US
Practice Address - Phone:978-464-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2011-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA32762208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology