Provider Demographics
NPI:1790760627
Name:SMITH, CINDY (MD)
Entity Type:Individual
Prefix:
First Name:CINDY
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13605 XAVIER LN STE B
Mailing Address - Street 2:
Mailing Address - City:BROOMFIELD
Mailing Address - State:CO
Mailing Address - Zip Code:80023-3603
Mailing Address - Country:US
Mailing Address - Phone:720-379-3013
Mailing Address - Fax:303-468-8793
Practice Address - Street 1:13605 XAVIER LN STE B
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80023-3603
Practice Address - Country:US
Practice Address - Phone:720-379-3013
Practice Address - Fax:303-468-8793
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-14
Last Update Date:2011-02-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CO31308207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine