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General NPI Number Information
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NPI Number | 1174619613
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Entity Type | Individual
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Provider Name | LAURIE JOAN SMITH MD
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Gender | Female
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Dates
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Enumeration Date | 10/04/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 6900 GEORGIA AVE ALLERGY CLINIC 1J96 WALTER REED ARMY MEDICAL CENTER
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City | WASHINGTON
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State | DC
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Zip | 20906
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Country | US
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Telephone | 202-782-7634
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Fax | 202-782-7093
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Provider Business Mailing Address
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Address Line | 3714 CAPULET TERRACE
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City | SILVER SPRING
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State | MD
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Zip | 20906
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Country | US
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Telephone | 301-598-2135
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Fax | 301-598-7102
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207K00000X
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Taxonomy Name | Allergy & Immunology Physician
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License Number | 0101033433
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License Number State | VA
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