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NPI Code Detail

MEDICARE: MARCUS JAMES SMITH MD

MEDICARE: MARCUS JAMES SMITH MD
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
1208100000XPhysical Medicine & Rehabilitation Physician0101250310VA

General Provider Information

NPI Number : 1477750834
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARCUS JAMES SMITH MD
Provider Business Mailing Address
First Line : 856 J CLYDE MORRIS BLVD
Second Line : SUITE A
City : NEWPORT NEWS
State : VA
Zip : 23601-1318
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 245 CHESAPEAKE AVE
Second Line :
City : NEWPORT NEWS
State : VA
Zip : 23607-6038
Country : US
Telephone Number : 757-534-9770
Fax Number : 757-928-8045
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/29/2007
Last Update Date : 04/10/2014

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