Smith, Andrew Gerald

Smith, Andrew Gerald is an individual health care provider with primary practice located at 100 Mario Capecchi Dr , Salt Lake City UT 84113-1103. He recently has 3 registered licenses in different health care specialties including Other Service Providers / Legal Medicine, Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine, Allopathic & Osteopathic Physicians / Pediatrics. Allopathic & Osteopathic Physicians / Pediatrics is his primary health care specialty. Smith, Andrew Gerald can be contacted via phone (801) 662-3673.

Contact Information

Primary practice address
100 Mario Capecchi Dr Salt Lake City UT 84113-1103
Phone: (801) 662-3673
Fax: (801) 662-3664
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X TL3586 Idaho
Allopathic & Osteopathic Physicians / Pediatric Critical Care Medicine 2080P0203X 5412561-1205 Utah
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 5412561-1205 Utah

Profile Details

NPI number 1033111810
LBN Legal business name Smith, Andrew Gerald
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 11th, 2005
Last updated Jun 22nd, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1033111810 NPPES
Idaho MEDICAID 807219800

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