Smith, Charles Michael
Smith, Charles Michael is an sole proprietor health care provider with primary practice located at 333 N 2Nd St Suite # 304, Niles MI 49120-2258. He recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as his primary health care specialty. Smith, Charles Michael can be contacted via phone (269) 687-9364.Contact Information
Primary practice address
333 N 2Nd St Suite # 304
Niles MI 49120-2258
Phone: (269) 687-9364
Fax: (269) 782-5344
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 103TC0700X | 6301008141 | Michigan |
Profile Details
| NPI number | 1790838811 |
|---|---|
| LBN Legal business name | Smith, Charles Michael |
| Credentials | PH.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 19th, 2007 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790838811 | NPPES |
| Michigan | Other | 68-0-A1-3124 | BCBSN PARTICIPATING PROV |
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