Provider Demographics
NPI:1255386421
Name:SMITH, STEVEN SCOTT (MD)
Entity type:Individual
Prefix:
First Name:STEVEN
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 1:399 FARMINGTON AVE
Mailing Address - Street 2:SUITE 210
Mailing Address - City:FARMINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06032-1936
Mailing Address - Country:US
Mailing Address - Phone:860-548-7338
Mailing Address - Fax:860-524-2654
Practice Address - Street 1:399 FARMINGTON AVE
Practice Address - Street 2:SUITE 210
Practice Address - City:FARMINGTON
Practice Address - State:CT
Practice Address - Zip Code:06032-1936
Practice Address - Country:US
Practice Address - Phone:860-548-7338
Practice Address - Fax:860-524-2654
Is Sole Proprietor?:No
Enumeration Date:2006-05-24
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT044322208200000X, 2082S0105X, 2086S0122X, 2082S0099X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
No208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery
No2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the Hand
No2082S0099XAllopathic & Osteopathic PhysiciansPlastic SurgeryPlastic Surgery Within the Head and Neck
Provider Identifiers
StateIdentifier IDID TypeIssuer
CT061406459OtherCOLONIAL COOPERATIVE CARE
CT061406459OtherMULTIPLAN
CT2V7899OtherHEALTH NET
CT061406459OtherUNITED HEALTHCARE
CT061406459OtherHMC, PPO
CT061406459OtherNORTHEAST HEALTH DIRECT
CT1323437OtherAETNA
MA2124106Medicaid
CT001443225Medicaid
CT061406459OtherHEALTH NEW ENGLAND
CT061406459OtherCORVEL CORP.
CT061406459OtherGREAT-WEST HEALTHCARE
CT7529562OtherCIGNA
CT044322OtherCONNECTICARE
CT010044322CT01OtherANTHEM BLUE CROSS BLUE SH
CT06-1406459OtherWORKERS' COMP TRUST
CT06-1406459OtherFOCUS
CTP3712122OtherOXFORD
CT2V7899OtherHEALTH NET
CT061406459OtherCORVEL CORP.