Provider Demographics
NPI:1851434005
Name:SMITH, STEVEN RICHARD (MD)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:RICHARD
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 1:12315 HANCOCK ST
Mailing Address - Street 2:SUITE - 26
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5884
Mailing Address - Country:US
Mailing Address - Phone:317-574-9797
Mailing Address - Fax:
Practice Address - Street 1:12315 HANCOCK ST
Practice Address - Street 2:SUITE - 26
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5884
Practice Address - Country:US
Practice Address - Phone:317-574-9797
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2008-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01026371A2083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine