Healthcare Provider Details

I. General information

NPI: 1336118660
Provider Name (Legal Business Name): DARLENE P SMALLMAN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/17/2006
Last Update Date: 05/27/2021
Certification Date: 05/27/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

700 2ND ST NE
WASHINGTON DC
20002-8100
US

IV. Provider business mailing address

PO BOX 6206
FALLS CHURCH VA
22040-6206
US

V. Phone/Fax

Practice location:
  • Phone: 202-346-3974
  • Fax:
Mailing address:
  • Phone: 703-697-3255
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA 061897
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number4380
License Number StateAK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: