Mark W Smith MD PLC LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

4301076489 Issued in MI

Legal business name

MARK W SMITH MD PLC LLC

Practice address

14705 W Upright St
Charlevoix, MI 49720-1949

Phone

(231) 547-6510

Fax

(231) 547-7456

NPI assigned

Jun 3, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mark William Smith, MDNPI 1750484879

Title

Managing Member

Phone

(231) 547-6510

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mark William Smith, MD

  • Family Medicine Physician
  • Charlevoix, MI
  • NPI 1750484879
  NPD (past) Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1232496000000",
    "number": "1144489444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14705 W UPRIGHT ST",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201949",
            "telephone_number": "231-547-6510",
            "fax_number": "231-547-7456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14705 W UPRIGHT ST",
            "city": "CHARLEVOIX",
            "state": "MI",
            "postal_code": "497201949",
            "telephone_number": "231-547-6510",
            "fax_number": "231-547-7456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MARK W SMITH MD PLC LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-03",
        "last_updated": "2009-01-21",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "MARK",
        "authorized_official_middle_name": "WILLIAM",
        "authorized_official_title_or_position": "MANAGING MEMBER",
        "authorized_official_telephone_number": "231-547-6510",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "MI",
            "license": "4301076489",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "B002922530",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Roger Maillefer, M.D.
• Melissa Sue Makowski, DDS
• Matthew Scott Manker, LMSW
• Daniel M Mann, M.D.
• Mark R McMurray
• Marla Ane Marrs
• Nina Kay Martenson, TLLP
• Sandra Lee Martin, WHNP-BC
• Maxwell Newman Smith Psychotherapy
• Leah M Mayotte, MA, LPC, CAADC, EMDR

• Family Medicine Physician in Charlevoix, MI
• Providers in Charlevoix, MI by specialty
• Family Medicine Physician in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.