Healthcare Provider Details

I. General information

NPI: 1629122866
Provider Name (Legal Business Name): DR EMILY J MAYHEW AND DR EDWARD SMITH, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1238 WEST WASHINGTON STREET
HARPERS FERRY WV
25425
US

IV. Provider business mailing address

PO BOX 200
HARPERS FERRY WV
25425-0200
US

V. Phone/Fax

Practice location:
  • Phone: 304-535-2409
  • Fax: 304-535-2408
Mailing address:
  • Phone: 304-535-2409
  • Fax: 304-535-2408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number732972
License Number StateWV

VIII. Authorized Official

Name: DR. EMILY J MAYHEW
Title or Position: PRESIDENT
Credential: DDS
Phone: 304-535-2409