Provider Demographics
NPI:1093100869
Name:SMITH, ANDREW HART (MD)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:HART
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:100 BEARD SAWMILL RD STE 250
Mailing Address - Street 2:
Mailing Address - City:SHELTON
Mailing Address - State:CT
Mailing Address - Zip Code:06484-6178
Mailing Address - Country:US
Mailing Address - Phone:203-922-7870
Mailing Address - Fax:203-922-7872
Practice Address - Street 1:100 BEARD SAWMILL RD STE 250
Practice Address - Street 2:
Practice Address - City:SHELTON
Practice Address - State:CT
Practice Address - Zip Code:06484-6178
Practice Address - Country:US
Practice Address - Phone:203-922-7870
Practice Address - Fax:203-922-7872
Is Sole Proprietor?:Yes
Enumeration Date:2015-03-30
Last Update Date:2024-09-25
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CT721932086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular SurgeryGroup - Single Specialty