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Provider Information for 1609846096

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

DR. EDWARD R. SMITH M.D.

Gender: MALE

Individual NPI: 1609846096

Calendar   Last Updated:  2018-04-17
  Certification Date: 

Details

Name Value
NPI 1609846096
Enumeration Date 2006-01-26
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 300 LONGWOOD AVE BADER 3
BOSTON, MA 02115-5724
United States

Phone: 617-355-8414 | Fax: 617-730-0906
View Map External Link
Primary Practice Address 300 LONGWOOD AVE BADER 3
BOSTON, MA 02115-5724
United States

Phone: 617-355-8414 | Fax: 617-730-0906
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Other MEDICAID HEALTH KIDS NH 30203759
Other TUFTS HEALTH PLAN MA 710422
Other BCBS MA M14829
MEDICAID MA 9757597
Other AETNA MA 3159607
Other TUFTS HEALTH MA 710422
Other VT MEDICAID VT 1010970
Other HARVARD PILGRIM HEALTH MA AA8312
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 207T00000X - Neurological Surgery MA 161140