Healthcare Provider Details

I. General information

NPI: 1639522246
Provider Name (Legal Business Name): WILLIAM SHERWOOD SMITH FNP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2016
Last Update Date: 08/02/2023
Certification Date: 10/29/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8908 RIGGS RD
ADELPHI MD
20783-1632
US

IV. Provider business mailing address

8908 RIGGS RD
ADELPHI MD
20783-1632
US

V. Phone/Fax

Practice location:
  • Phone: 214-693-5790
  • Fax:
Mailing address:
  • Phone: 214-693-5790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN1032225
License Number StateDC
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR215271
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: