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1902060551

NPI Code Detail

MEDICARE: DAVID SMOGER MD

MEDICARE: DAVID SMOGER 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
1	2085R0202X	Diagnostic Radiology Physician	MD427228	PA
2	2085R0204X	Vascular & Interventional Radiology Physician	ME163667	FL
3	390200000X	Student in an Organized Health Care Education/Training Program	MT182000	PA
4	2085R0204X	Vascular & Interventional Radiology Physician	MT182000	PA

General Provider Information

NPI Number	:	1902060551
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID SMOGER MD

Provider Business Mailing Address
First Line	:	1415 WESLEYS RUN
Second Line	:
City	:	GLADWYNE
State	:	PA
Zip	:	19035-1049
Country	:	US
Telephone Number	:	267-939-5788
Fax Number	:

Provider Business Practice Location Address
First Line	:	8375 DIX ELLIS TRL STE 201
Second Line	:
City	:	JACKSONVILLE
State	:	FL
Zip	:	32256-8241
Country	:	US
Telephone Number	:	215-662-3264
Fax Number	:

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

Provider Enumeration Date	:	07/14/2008
Last Update Date	:	04/12/2024

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Directions to “ DAVID SMOGER MD” Practice Location

Language	Start Address	Practice Location

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