| Doctor Name: | DR. MICHAEL T. SMOLKA |
| NPI Number: | 1194014290 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | D.O. |
| License Number: | 963 |
| Business Practice Address: | 3851 Roger Brooke Dr Brooke Army Medical Center, Pediatric Residency Program Fort Sam Houston, TX - 782344501 |
| Business Phone Number: | 2109169928 |
| Business Fax Number: | 2109169332 |
| Mailing Address: | 3851 Roger Brooke Dr, Brooke Army Medical Center, Pediatric Residency Program FORT SAM HOUSTON |
| State: | TX |
| Postal Code: | 782344501 |
| Phone Number: | 2109169928 |
| Fax Number: | 2109169332 |
| NPI Enumeration Date: | 03/30/2011 |
| NPI Last Update Date: | 04/29/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 963 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NE |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |