Provider Demographics
NPI:1083436026
Name:SMITH, CHRISTIAN MICHAEL (PHARMD)
Entity type:Individual
Prefix:
First Name:CHRISTIAN
Middle Name:MICHAEL
Last Name:SMITH
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:264 SMITH TOWNSHIP STATE RD STE 5
Mailing Address - Street 2:
Mailing Address - City:BURGETTSTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:15021-2124
Mailing Address - Country:US
Mailing Address - Phone:724-414-1425
Mailing Address - Fax:
Practice Address - Street 1:264 SMITH TOWNSHIP STATE RD STE 5
Practice Address - Street 2:
Practice Address - City:BURGETTSTOWN
Practice Address - State:PA
Practice Address - Zip Code:15021-2124
Practice Address - Country:US
Practice Address - Phone:724-414-1425
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202220135183500000X
KS1-116111183500000X
MD28326183500000X
OH03441743183500000X
FLPS64022183500000X
DCPH200004264183500000X
PARP456024183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist