Healthcare Provider Details

I. General information

NPI: 1700695491
Provider Name (Legal Business Name): SMARTCARE MEDICAL ASSOCIATES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/06/2025
Last Update Date: 01/06/2025
Certification Date: 01/06/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11701 LIVINGSTON RD STE 208
FORT WASHINGTON MD
20744-5136
US

IV. Provider business mailing address

PO BOX 260
OXON HILL MD
20750-0260
US

V. Phone/Fax

Practice location:
  • Phone: 240-667-0800
  • Fax: 240-667-0801
Mailing address:
  • Phone: 240-667-0800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KANIA THOMAS
Title or Position: PRACTICE DIRECTOR
Credential: MBA
Phone: 301-741-5739