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DR. TERRENCE EDWARD SMITH M.D.

>> Family Medicine >> Allopathic & Osteopathic Physicians

Registrant NPI Number: 1629152897

Individual Registrant:
DR. TERRENCE EDWARD SMITH M.D.
Gender: M
Sole Proprietor

Location and contact information for practice:
52992 SACRAMENTO STREET BOX 69 CLARKSBURG, CA 95612-0069 US
Tel: 916-744-1081  Fax: --

Contact information for business:
52992 SACRAMENTO STREET BOX 69 CLARKSBURG, CA 95612-0069 US
Tel: 916-744-1081  Fax: --

Registration Information:
NPI: 1629152897
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y207Q00000XAllopathic & Osteopathic Physicians
Family Medicine
CAG 42590

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
00G425900CA05




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