Healthcare Provider Details

I. General information

NPI: 1457360349
Provider Name (Legal Business Name): KAREN LISA SMITH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/07/2006
Last Update Date: 12/03/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 IRVING ST NW # 2A38
WASHINGTON DC
20010-2976
US

IV. Provider business mailing address

110 IRVING ST NW # 2A38
WASHINGTON DC
20010-2976
US

V. Phone/Fax

Practice location:
  • Phone: 202-877-2829
  • Fax:
Mailing address:
  • Phone: 202-877-2829
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD035950
License Number StateDC
# 2
Primary TaxonomyN
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberD58594
License Number StateMD
# 3
Primary TaxonomyY
Taxonomy Code207RX0202X
TaxonomyMedical Oncology Physician
License NumberMD035950
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: