Provider Demographics
NPI:1134415839
Name:SMITH, CHRISTOPHER SCOTT (MD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:SCOTT
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:37 HARTWELL RD
Mailing Address - Street 2:
Mailing Address - City:STRONG
Mailing Address - State:ME
Mailing Address - Zip Code:04983
Mailing Address - Country:US
Mailing Address - Phone:207-860-0404
Mailing Address - Fax:207-684-3251
Practice Address - Street 1:43 OWENS ST
Practice Address - Street 2:SOMERSET REHABILITATION CENTER
Practice Address - City:BINGHAM
Practice Address - State:ME
Practice Address - Zip Code:04920
Practice Address - Country:US
Practice Address - Phone:207-672-4041
Practice Address - Fax:207-672-3293
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-22
Last Update Date:2016-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ME6454207Q00000X
ME006454207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine