MICHAEL ELLSWORTH SMOTHERS

ELKHART, IN
NPI1477556918
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy207Q00000X Family Medicine
(Licence: IN  01042198)
Additional Taxonomies207QG0300X Family Medicine, Geriatric Medicine
(Licence: IN  01042198)
207Q00000X Family Medicine
(Licence: MI  4301042611)
Enumeration Date2005-05-28
Last Update Date2007-07-20
Business Address
Dr. MICHAEL ELLSWORTH SMOTHERS M.D.
3003 E LAKE DR S
ELKHART, IN 46514-4327
Phone number: 574-206-0465
Mailing Address
Dr. MICHAEL ELLSWORTH SMOTHERS M.D.
3003 E LAKE DR S
ELKHART, IN 46514-4327
Phone number: 574-206-0465