| David J. Smith Md Pc | |
|
1035 Charlevoix Dr Ste 100 Grand Ledge MI 48837-2223 | |
| (517) 627-2181 | |
| (517) 622-1242 |
| Full Name | David J. Smith Md Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 1035 Charlevoix Dr Ste 100, Grand Ledge, Michigan |
| Authorized Official Name and Position | David J Smith (PRESIDENT) |
| Authorized Official Contact | 5176272181 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| David J. Smith Md Pc 1035 Charlevoix Dr Ste 100 Grand Ledge MI 48837-2223 Ph: (517) 627-2181 | David J. Smith Md Pc 1035 Charlevoix Dr Ste 100 Grand Ledge MI 48837-2223 Ph: (517) 627-2181 |
| NPI Number | 1669523650 |
|---|---|
| Provider Enumeration Date | 01/16/2007 |
| Last Update Date | 12/11/2017 |
| Medicare PECOS PAC ID | 2567431729 |
|---|---|
| Medicare Enrollment ID | O20040925000140 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669523650 | NPI | - | NPPES |
| 080B360240 | Other | MI | BCBSM GROUP NUMBER |
| C1769 | Other | MEDICARE RAILROAD |
| Provider Name | Robyn D Gazall |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1215019682 PECOS PAC ID: 2062514599 Enrollment ID: I20070301000167 |
| Provider Name | Edward D Ball |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750499083 PECOS PAC ID: 3678649712 Enrollment ID: I20080915000036 |
| Provider Name | Timothy J Izzo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1720152846 PECOS PAC ID: 5698899854 Enrollment ID: I20100825000766 |
| Provider Name | Eric G Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1689748725 PECOS PAC ID: 8729102892 Enrollment ID: I20100825001113 |
| Provider Name | David J Smith |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1275623662 PECOS PAC ID: 5193794352 Enrollment ID: I20101007000724 |
| Provider Name | Tracy Marie Wirth |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760795983 PECOS PAC ID: 0446442305 Enrollment ID: I20101011000323 |
| Provider Name | Jami M Devarona |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1356415491 PECOS PAC ID: 8729200431 Enrollment ID: I20141113001303 |
| Provider Name | Sandra G Brooks |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1578735155 PECOS PAC ID: 4284933151 Enrollment ID: I20160427000910 |
| Provider Name | Peter C Miller |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1043430606 PECOS PAC ID: 4981741782 Enrollment ID: I20160817001848 |
| Provider Name | Elizabeth T Stoumbos |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1639614373 PECOS PAC ID: 8820338213 Enrollment ID: I20190321001528 |
| Provider Name | Elizabeth Catherine Paine |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1679929343 PECOS PAC ID: 9537497987 Enrollment ID: I20190822001458 |
| Provider Name | Kelsie Lynne Barnhart |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013635648 PECOS PAC ID: 7113398595 Enrollment ID: I20230123000895 |
| Provider Name | Dominic Izzo |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1932723905 PECOS PAC ID: 6507289600 Enrollment ID: I20230612002875 |
| Provider Name | Jacob Monestersky |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1740804632 PECOS PAC ID: 4880017821 Enrollment ID: I20230615000725 |
| Provider Name | Lauren Victoria Greene |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750731725 PECOS PAC ID: 6507150224 Enrollment ID: I20231003002810 |
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