Healthcare Provider Details

I. General information

NPI: 1720346687
Provider Name (Legal Business Name): EMILY ANNE SMITHERMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/30/2012
Last Update Date: 08/31/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 4TH AVE S STE 610
BIRMINGHAM AL
35233
US

IV. Provider business mailing address

1880 RED MOUNTAIN LN UNIT F
BIRMINGHAM AL
35223-1093
US

V. Phone/Fax

Practice location:
  • Phone: 205-638-9438
  • Fax:
Mailing address:
  • Phone: 281-682-1374
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080P0216X
TaxonomyPediatric Rheumatology Physician
License Number37165
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: