Provider Demographics
NPI:1952395352
Name:SMIT, MICHAEL L (DO)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:L
Last Name:SMIT
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6880 W SNOWVILLE RD STE 215
Mailing Address - Street 2:
Mailing Address - City:BRECKSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:44141-3254
Mailing Address - Country:US
Mailing Address - Phone:440-565-5050
Mailing Address - Fax:
Practice Address - Street 1:730 MCKINLEY AVE NW
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:OH
Practice Address - Zip Code:44703-3404
Practice Address - Country:US
Practice Address - Phone:330-458-3000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2022-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH0733152W00000X, 152WC0802X
OH34.012627207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
NH09Y003825NH02OtherANTHEM NH
NH410047612OtherRAILROAD MEDICARE
NH30352041Medicaid
NH7366714001OtherCIGNA
NH7366714001OtherCIGNA
NH0141110001Medicare NSC
NHRE6682Medicare PIN