Doctor Name: | DR. MICHAEL OLIVER SMITH |
NPI Number: | 1174787212 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | M.D |
License Number: | 108541 |
Business Practice Address: | 3115 Broadway New York, NY - 100274608 |
Business Phone Number: | 7189933100 |
Business Fax Number: | 7182926138 |
Mailing Address: | 3115 Broadway, NEW YORK |
State: | NY |
Postal Code: | 100274608 |
Phone Number: | 7189933100 |
Fax Number: | 7182926138 |
NPI Enumeration Date: | 07/17/2008 |
NPI Last Update Date: | 07/17/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 2084A0401X |
License Number: | 108541 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | Psychiatry & Neurology |
Taxonomy Specialization: | Addiction Medicine |
Taxonomy Definition: | A doctor of osteopathy board eligible/certified in the field of Psychiatry by the American Osteopathic Board of Neurology and Psychiatry is able to obtain a Certificate of Added Qualifications in the field of Addiction Medicine |