Provider Demographics
NPI:1841289972
Name:SMITH, STEVEN D (MD)
Entity type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:D
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 1:9986 N WIND RIVER RUN
Mailing Address - Street 2:
Mailing Address - City:MCCORDSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:46055-9453
Mailing Address - Country:US
Mailing Address - Phone:740-501-0196
Mailing Address - Fax:351-222-8012
Practice Address - Street 1:155 W WASHINGTON ST STE 155
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46204-3496
Practice Address - Country:US
Practice Address - Phone:317-559-2185
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-10-20
Last Update Date:2023-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01068922A207Q00000X
OH35052435207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0762778Medicaid
OH0762778Medicaid
OH0762778Medicaid