Provider Demographics
NPI:1912454745
Name:STEVEN P.SMITH, MD
Entity Type:Organization
Organization Name:STEVEN P.SMITH, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JANET
Authorized Official - Middle Name:
Authorized Official - Last Name:WEISHAUS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:781-235-8855
Mailing Address - Street 1:332 WASHINGTON ST
Mailing Address - Street 2:SUITE# 355
Mailing Address - City:WELLESLEY HILLS
Mailing Address - State:MA
Mailing Address - Zip Code:02481-6219
Mailing Address - Country:US
Mailing Address - Phone:781-235-8855
Mailing Address - Fax:
Practice Address - Street 1:332 WASHINGTON ST
Practice Address - Street 2:SUITE# 355
Practice Address - City:WELLESLEY HILLS
Practice Address - State:MA
Practice Address - Zip Code:02481-6219
Practice Address - Country:US
Practice Address - Phone:781-235-8855
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-09-09
Last Update Date:2016-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ND0101XAllopathic & Osteopathic PhysiciansDermatologyMOHS-Micrographic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAA21780Medicare PIN