DR. MARK WILLIAM SMITH (NPI# 1750484879) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750484879 |
| Entity Type | Individual |
| Full Name | DR. MARK WILLIAM SMITH |
| Credential | MD |
| Practice Address |
14734 Park Ave Charlevoix MI 49720-1927 |
| Practice Telephone | 2315476554 |
| Practice Fax Number | 2315471179 |
| Mailing Telephone | 2315476554 |
| Mailing Fax Number | 2315471179 |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2014-07-02 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 4301076489 | MI | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| MI | 8002922550 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871025668 | Mark Robert Smith | Physical Therapist | 11448 Princessa Ln, Jacksonville, FL 32218-4054 | 2017-03-30 |
| 1982148565 | Mark Smith Jr. | Pharmacist | 2850 Venice Rd Sw, Apt 3303, Birmingham, AL 35211-6203 | 2016-12-15 |
| 1396124558 | Mark Andrew Smith | Physical Therapist | 125 S Mcdaniel Dr, Auburn, CA 95603-5742 | 2015-05-21 |
| 1760875181 | Mark Smith | Case Manager/Care Coordinator | 4028 Knollton Rd, Indianapolis, IN 46228-3332 | 2015-03-09 |
| 1366833154 | Mark James Smith | Pharmacist | 2627 Oneida St, Utica, NY 13501-6332 | 2015-02-15 |
| 1568869824 | Mark Smith | Occupational Therapy Assistant | 1160 Old State Rd, New Castle, PA 16101-6417 | 2014-12-01 |
| 1992128581 | Mark Harrison Smith | Case Manager/Care Coordinator | 346 Sycamore Ridge Way, Gahanna, OH 43230-5605 | 2014-02-03 |
| 1881967263 | Mark Steven Smith | Dentist | 7685 Wolf River Cir Ste 102, Germantown, TN 38138-1749 | 2012-02-16 |
| 1225328768 | Mark W Smith | Counselor | 2619 W. 6th St, Suite C, Lawrence, KS 66049 | 2011-04-18 |
| 1053628271 | Mark Thomas Smith | Optometrist | 592 Main St N, Mc Kenzie, TN 38201-1707 | 2010-09-09 |
| Street Address |
14734 PARK AVE |
| City | CHARLEVOIX |
| State | MI |
| Zip Code | 49720-1927 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538151212 | Roderic E Tinney | Pediatrics | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2005-08-18 |
| 1558904623 | Munson Healthcare Charlevoix Hospital | Clinic/Center | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2019-10-22 |
| 1114368321 | Chris Loewen | Family Medicine | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2013-07-16 |
| 1992074777 | Munson Healthcare Charlevoix Hospital | Pediatrics | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2011-12-22 |
| 1013173392 | Rachel Beth Newman | Pediatrics | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2008-08-05 |
| 1952596637 | Munson Healthcare Charlevoix Hospital | Emergency Medicine | 14734 Park Ave, Charlevoix, MI 49720-1931 | 2007-09-06 |
| 1063598845 | Munson Healthcare Charlevoix Hospital | Nurse Anesthetist, Certified Registered | 14734 Park Ave, Charlevoix, MI 49720-1931 | 2006-10-27 |
| 1649291048 | Cynthia Statler | Pediatrics | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2006-07-21 |
| 1538102694 | Pine River Medical Associates, P.C. | Specialist | 14734 Park Ave, Charlevoix, MI 49720 | 2006-06-14 |
| 1659363299 | Melodie R Brown | Family Medicine | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2005-08-19 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609477488 | Munson Healthcare Charlevoix Hospital | Urology | 11695 Park Ave, Suite A, Charlevoix, MI 49720 | 2020-11-06 |
| 1215587498 | Amanda Evans | Dietitian, Registered | 09210 North Pointe Woods Drive, Charlevoix, MI 49720 | 2019-09-18 |
| 1508229980 | Charlevoix Physicians Clinic | Specialist | 14709 W. Upright, Charlevoix, MI 49720 | 2016-04-01 |
| 1881014348 | Tracy Skinner | Social Worker | 220 W. Garfield Ave, Charlevoix, MI 49720 | 2014-04-23 |
| 1720414097 | Jennifer Jean Swenor | Occupational Therapist | 10270 Burnett Rd, Charlevoix, MI 49720 | 2013-09-18 |
| 1801171863 | Leslie Lukins | Pharmacist | 1500 Bridge Street, Charlevoix, MI 49720 | 2011-10-20 |
| 1164670949 | Northwest Michigan Community Health Agency | Hospice Care, Community Based | 220 W Garfield Street, Charlevoix, MI 49720 | 2008-09-04 |
| 1275722191 | Robert Dennis Cook | Pharmacist | 301 Bridge Street, Charlevoix, MI 49720 | 2007-10-16 |
| 1629191648 | Susan Mary Killam | Nurse Practitioner | Northwest Michigan Community Health Agency, 220 W. Garfield Street, Charlevoix, MI 49720 | 2007-04-06 |
| 1851410153 | Joelle M Beaudoin | Specialist/Technologist | 06510 M-66 N, Charlevoix, MI 49720 | 2007-03-28 |
| Find all providers in zip 49720 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548606916 | Benjamin Joseph Edwards | Family Medicine | 14709 W Upright St, Charlevoix, MI 49720-1949 | 2013-05-13 |
| 1326124058 | Munson Healthcare Charlevoix Hospital | Family Medicine | 14709 W. Upright Street, Charlevoix, MI 49720-1949 | 2006-10-27 |
| 1427141373 | John Hayden Lignell | Family Medicine | 14695 Park Avenue, Charlevoix, MI 49720 | 2006-10-02 |
| 1376534495 | Anna G Young | Family Medicine | 14705 W Upright St, Charlevoix, MI 49720-1949 | 2005-10-31 |
| 1114368321 | Chris Loewen | Family Medicine | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2013-07-16 |
| 1144489444 | Mark W Smith Md Plc LLC | Family Medicine | 14705 W Upright St, Charlevoix, MI 49720-1949 | 2008-06-03 |
| 1710079256 | Geralyn Doskoch | Family Medicine | 14705 W Upright St, Charlevoix, MI 49720-1949 | 2006-09-29 |
| 1730292392 | Lakeshore Sleep Medicine Plc | Family Medicine | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2006-08-17 |
| 1699794958 | Nathan Craig Boss | Family Medicine | 14700 Lake Shore Dr, Charlevoix, MI 49720-1931 | 2006-07-18 |
| 1659363299 | Melodie R Brown | Family Medicine | 14734 Park Ave, Charlevoix, MI 49720-1927 | 2005-08-19 |
| Find all providers in CHARLEVOIX | ||||
| City | CHARLEVOIX |
| Zip Code | 49720 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.