MEDICARE: SMITA P. MENGERS, 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	208000000X	Pediatrics Physician

General Provider Information

NPI Number	:	1932481348
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMITA P. MENGERS, MD

Provider Business Mailing Address
First Line	:	19803 EXECUTIVE PARK CIR
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-2649
Country	:	US
Telephone Number	:	301-540-7496
Fax Number	:	301-540-0772

Provider Business Practice Location Address
First Line	:	19803 EXECUTIVE PARK CIR
Second Line	:
City	:	GERMANTOWN
State	:	MD
Zip	:	20874-2649
Country	:	US
Telephone Number	:	301-540-7496
Fax Number	:	301-540-0772

Authorized Official
Title or Position	:	MD/OWNER
Name	:	DR. SMITA P MENGERS
Credential	:	MD
Telephone Number	:	301-540-7496

Provider Enumeration Date	:	09/12/2011
Last Update Date	:	09/12/2011

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