Healthcare Provider Details

I. General information

NPI: 1831757194
Provider Name (Legal Business Name): KATHIA TAWANA SHINAD SMITH MD MS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/03/2019
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 PENNSYLVANIA AVE NW
WASHINGTON DC
20037-3201
US

IV. Provider business mailing address

2150 PENNSYLVANIA AVE NW
WASHINGTON DC
20037-3201
US

V. Phone/Fax

Practice location:
  • Phone: 202-741-3000
  • Fax:
Mailing address:
  • Phone: 202-741-3000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD210012080
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: