MEDICARE: KATHERINE SMYTH M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	0101056434	VA

General Provider Information

NPI Number	:	1316991227
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KATHERINE SMYTH M.D.

Provider Business Mailing Address
First Line	:	PO BOX 79777
Second Line	:
City	:	BALTIMORE
State	:	MD
Zip	:	21279-0777
Country	:	US
Telephone Number	:	434-654-7794
Fax Number	:	434-654-7752

Provider Business Practice Location Address
First Line	:	33 REBECCA DR
Second Line	:
City	:	PALMYRA
State	:	VA
Zip	:	22963-6242
Country	:	US
Telephone Number	:	434-654-4680
Fax Number	:	434-589-6688

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	08/11/2023

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