Provider Demographics
NPI:1982653630
Name:SMITH, MATTHEW E (MD)
Entity Type:Individual
Prefix:DR
First Name:MATTHEW
Middle Name:E
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:425 ESSJAY RD STE 170
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14221-8235
Mailing Address - Country:US
Mailing Address - Phone:716-630-1000
Mailing Address - Fax:716-817-1726
Practice Address - Street 1:85 HIGH ST
Practice Address - Street 2:
Practice Address - City:BUFFALO
Practice Address - State:NY
Practice Address - Zip Code:14203-1149
Practice Address - Country:US
Practice Address - Phone:716-630-1000
Practice Address - Fax:716-859-4017
Is Sole Proprietor?:No
Enumeration Date:2006-05-09
Last Update Date:2021-12-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY224904208M00000X
NY224904-1207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY0411620OtherIHA
NYP00018155OtherRR MEDICARE
NY000527280001OtherHEALTH NOW
NY02383195Medicaid
NY00026280301OtherUNIVERA
NY161000580OtherNORH AMERICAN PREFERRED
NY161000580OtherAETNA
NY161000580OtherEMPIRE
NY161000580OtherNOVA
NYP00018155OtherRR MEDICARE
NY02383195Medicaid