Healthcare Provider Details

I. General information

NPI: 1215563218
Provider Name (Legal Business Name): JOSHUA ABRAHAM SMITH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2020
Last Update Date: 06/06/2026
Certification Date: 06/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4151 BLADENSBURG RD
COLMAR MANOR MD
20722-1928
US

IV. Provider business mailing address

4000 RESERVOIR RD NW BLD D, ROOM 234
WASHINGTON DC
20007-2145
US

V. Phone/Fax

Practice location:
  • Phone: 301-699-7700
  • Fax: 301-779-9001
Mailing address:
  • Phone: 202-687-1275
  • Fax: 202-687-1651

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberD0102983
License Number StateMD
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD600003802
License Number StateDC
# 3
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: