Healthcare Provider Details
I. General information
NPI: 1982138335
Provider Name (Legal Business Name): SMARTBRIDGE INC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/12/2017
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1301 M ST NW SUITE 818
WASHINGTON DC
20005-4201
US
IV. Provider business mailing address
1301 M STREET NW, SUITE 818
WASHINGTON DC
20005
US
V. Phone/Fax
- Phone: 917-721-3644
- Fax:
- Phone: 917-721-3644
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RH0003X |
| Taxonomy | Hematology & Oncology Physician |
| License Number | |
| License Number State | DC |
VIII. Authorized Official
Name: MS.
HUA
WANG
Title or Position: CEO
Credential:
Phone: 917-721-3644