Healthcare Provider Details

I. General information

NPI: 1205816899
Provider Name (Legal Business Name): LAMONT CHARLES SMITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/19/2006
Last Update Date: 08/18/2025
Certification Date: 08/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22 S GREENE ST DEPT OF SURGERY
BALTIMORE MD
21201-1544
US

IV. Provider business mailing address

2095 MOUNT HEBRON DR
ELLICOTT CITY MD
21042-1851
US

V. Phone/Fax

Practice location:
  • Phone: 410-328-1168
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberD0052950
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberME114831
License Number StateFL
# 3
Primary TaxonomyN
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License NumberD0052950
License Number StateMD
# 4
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberME114831
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: