Smith, Michael David

Smith, Michael David is an individual health care provider with primary practice located at 3019 Peoples St # Condo300 , Johnson City TN 37604-1977. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, which is considered as his primary health care specialty. Smith, Michael David can be contacted via phone (423) 461-2100.

Contact Information

Primary practice address
3019 Peoples St # Condo300 Johnson City TN 37604-1977
Phone: (423) 461-2100
Fax: (423) 461-2199
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X APN7641 Tennessee

Profile Details

NPI number 1003819707
LBN Legal business name Smith, Michael David
Credentials NURSE PRACTITIONER
Entity Individual
Sole proprietor 1 No
Enumeration date May 27th, 2005
Last updated Mar 7th, 2023 - about 2 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 1003819707 NPPES
Tennessee MEDICAID 3347731
Tennessee Other APN7641
Tennessee Other RN115963

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