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Contact Information

KENDRA M BLACK SMITH, MD
2003 KOOTENAI HEALTH WAY
COEUR D'ALENE, ID83814
 Phone: 208-625-5185
 Fax: 208-625-6892
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Neonatal-Perinatal Medicine

2080N0001X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for KENDRA M BLACK SMITH · (Female)

NPI Number 1790866044
Status Active
Credentials MD
Entity Individual
Enumeration date 10/17/2006
Last updated 04/03/2019 - About 7 years ago
Sole proprietor 1 No
Identifiers
  • ID License # M14495
  • WA License # MD00039197
  • WA Medicaid 8269235
  • Other 272030 INTERNAL ID-MOTOR VEHICLE ID
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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