| Peter Trent Smith Md Pc | |
|
3410 E 12 Mile Rd Ste B Warren MI 48092-2593 | |
| (586) 383-0920 | |
| (586) 920-2503 |
| Full Name | Peter Trent Smith Md Pc |
|---|---|
| Speciality | Psychiatry & Neurology |
| Location | 3410 E 12 Mile Rd Ste B, Warren, Michigan |
| Authorized Official Name and Position | Peter Trent Smith (PRESIDENT) |
| Authorized Official Contact | 5863830920 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Peter Trent Smith Md Pc 3410 E 12 Mile Rd Ste B Warren MI 48092-2593 Ph: (586) 383-0920 | Peter Trent Smith Md Pc 3410 E 12 Mile Rd Ste B Warren MI 48092-2593 Ph: (586) 383-0920 |
| NPI Number | 1548275241 |
|---|---|
| Provider Enumeration Date | 07/30/2006 |
| Last Update Date | 08/01/2022 |
| Certification Date | 05/04/2021 |
| Medicare PECOS PAC ID | 3274763529 |
|---|---|
| Medicare Enrollment ID | O20140305001967 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548275241 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084P0800X | Psychiatry & Neurology - Psychiatry | 4301053454 (Michigan) | Primary |
| Provider Name | Peter T Smith |
|---|---|
| Provider Type | Practitioner - Psychiatry |
| Provider Identifiers | NPI Number: 1750458386 PECOS PAC ID: 8123187861 Enrollment ID: I20081110000456 |
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