Healthcare Provider Details

I. General information

NPI: 1497662431
Provider Name (Legal Business Name): EMILY SMALLWOOD PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2026
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

25500 POINT LOOKOUT RD
LEONARDTOWN MD
20650-2015
US

IV. Provider business mailing address

26485 MEADOW WOOD DR
MECHANICSVILLE MD
20659-2569
US

V. Phone/Fax

Practice location:
  • Phone: 301-475-8981
  • Fax:
Mailing address:
  • Phone: 443-386-5579
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: