Provider Demographics
NPI:1588453286
Name:SMITH, TILMIRA (MD)
Entity type:Individual
Prefix:
First Name:TILMIRA
Middle Name:
Last Name:SMITH
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1511 1ST ST APT 1205
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48226-1361
Mailing Address - Country:US
Mailing Address - Phone:313-932-9862
Mailing Address - Fax:
Practice Address - Street 1:24911 LITTLE MACK AVE STE C
Practice Address - Street 2:
Practice Address - City:SAINT CLAIR SHORES
Practice Address - State:MI
Practice Address - Zip Code:48080-3200
Practice Address - Country:US
Practice Address - Phone:586-777-2050
Practice Address - Fax:586-777-2189
Is Sole Proprietor?:No
Enumeration Date:2025-05-01
Last Update Date:2025-05-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program