Provider Demographics
NPI:1306816889
Name:SMITH, CINDI K (MD)
Entity type:Individual
Prefix:
First Name:CINDI
Middle Name:K
Last Name:SMITH
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Gender:F
Credentials:MD
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Mailing Address - Street 1:601 JOHN ST
Mailing Address - Street 2:SUITE M-020
Mailing Address - City:KALAMAZOO
Mailing Address - State:MI
Mailing Address - Zip Code:49007-5341
Mailing Address - Country:US
Mailing Address - Phone:269-341-8400
Mailing Address - Fax:269-341-8427
Practice Address - Street 1:601 JOHN ST
Practice Address - Street 2:BRONSON INTERNAL MEDICINE-DOWNTOWN STE M020
Practice Address - City:KALAMAZOO
Practice Address - State:MI
Practice Address - Zip Code:49007-5341
Practice Address - Country:US
Practice Address - Phone:269-341-8400
Practice Address - Fax:269-341-8427
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2020-11-18
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Provider Licenses
StateLicense IDTaxonomies
MI4301063409207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4178080Medicaid
MICB9054OtherRAILROAD MEDICARE
MI4178080Medicaid
MIM20520020Medicare PIN