Smith, Theresa Marie
Smith, Theresa Marie is an individual health care provider with primary practice located at 400 E 3Rd St , Duluth MN 55805-1951. She recently has only one registered license in Allopathic & Osteopathic Physicians / Gastroenterology, which is considered as her primary health care specialty. Smith, Theresa Marie can be contacted via phone (218) 786-8364.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Gastroenterology | 207RG0100X | 31478 | Minnesota |
Profile Details
| NPI number | 1215971221 |
|---|---|
| LBN Legal business name | Smith, Theresa Marie |
| Credentials | |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2006 |
| Last updated | May 9th, 2011 - about 15 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 | 1215971221 | NPPES |
| Wisconsin | MEDICAID | 31549400 |
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400 E 3Rd St Essentia Health Duluth Clinic, Duluth MN 55805-1951