Healthcare Provider Details

I. General information

NPI: 1821359845
Provider Name (Legal Business Name): CHRISTINA MARIE SMITH-WINFIELD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHRISTINA MARIE SMITH MD

II. Dates (important events)

Enumeration Date: 06/06/2012
Last Update Date: 05/12/2020
Certification Date: 05/12/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2675 N DECATUR RD
DECATUR GA
30033-6131
US

IV. Provider business mailing address

2675 N DECATUR RD
DECATUR GA
30033-6131
US

V. Phone/Fax

Practice location:
  • Phone: 404-501-1000
  • Fax:
Mailing address:
  • Phone: 404-501-1000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number076206
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number76206
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: