Provider Demographics
NPI:1285923649
Name:SMITH, RILEY M (MD)
Entity type:Individual
Prefix:DR
First Name:RILEY
Middle Name:M
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:26901 BEAUMONT BLVD STE 3D
Mailing Address - Street 2:
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48033-3849
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:18181 OAKWOOD BLVD
Practice Address - Street 2:STE 411
Practice Address - City:DEARBORN
Practice Address - State:MI
Practice Address - Zip Code:48124-4082
Practice Address - Country:US
Practice Address - Phone:313-438-7373
Practice Address - Fax:313-438-7375
Is Sole Proprietor?:No
Enumeration Date:2011-04-06
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5315057754208100000X, 208100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & Rehabilitation