Healthcare Provider Details

I. General information

NPI: 1841619723
Provider Name (Legal Business Name): CARA W SMITH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARA S WEINER MD

II. Dates (important events)

Enumeration Date: 04/08/2014
Last Update Date: 07/11/2022
Certification Date: 07/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 CIVIC AVE
SALISBURY MD
21804
US

IV. Provider business mailing address

200 CIVIC AVE
SALISBURY MD
21804
US

V. Phone/Fax

Practice location:
  • Phone: 410-749-1466
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number074596
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number0101270119
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number074596
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number0101270119
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: