Healthcare Provider Details

I. General information

NPI: 1457506412
Provider Name (Legal Business Name): RICHARD CYLE SMITH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/18/2008
Last Update Date: 11/18/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

637 ALABAMA AVE SE
WASHINGTON DC
20032-4104
US

IV. Provider business mailing address

637 ALABAMA AVE SE
WASHINGTON DC
20032-4104
US

V. Phone/Fax

Practice location:
  • Phone: 202-563-0193
  • Fax:
Mailing address:
  • Phone: 202-563-0193
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD8916
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: