Healthcare Provider Details

I. General information

NPI: 1851674170
Provider Name (Legal Business Name): MARGO B SMITH NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGO T BALTIMORE NP

II. Dates (important events)

Enumeration Date: 09/22/2011
Last Update Date: 04/17/2025
Certification Date: 04/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3253 TAYLOR RD SUITE 200
CHESAPEAKE VA
23321-2452
US

IV. Provider business mailing address

7007 HARBOUR VIEW BLVD SUITE 108
SUFFOLK VA
23435-3657
US

V. Phone/Fax

Practice location:
  • Phone: 757-686-5673
  • Fax: 757-686-8694
Mailing address:
  • Phone: 757-215-2784
  • Fax: 757-215-2728

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0024169442
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: