Healthcare Provider Details

I. General information

NPI: 1619964046
Provider Name (Legal Business Name): RAMADA SHERICE SMITH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 06/20/2023
Certification Date: 06/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2202 STATE AVE STE 207
PANAMA CITY FL
32405-4582
US

IV. Provider business mailing address

2202 STATE AVE STE 207
PANAMA CITY FL
32405-4582
US

V. Phone/Fax

Practice location:
  • Phone: 850-874-1856
  • Fax: 850-784-1975
Mailing address:
  • Phone: 850-874-1856
  • Fax: 850-784-1975

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number200400599
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License NumberME151746
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: