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General NPI Number Information
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NPI Number | 1326239575
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Entity Type | Individual
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Provider Name | MARY NANNA SMITH MD
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Gender | Female
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Dates
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Enumeration Date | 08/05/2007
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Last Update Date | 05/14/2013
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Provider Practice Location Address
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Address Line | 2000 MEDICAL PKWY SUITE 304
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City | ANNAPOLIS
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State | MD
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Zip | 21401-3742
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Country | US
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Telephone | 410-573-9530
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Fax | 410-573-9569
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Provider Business Mailing Address
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Address Line | 3299 WOODBURN RD SUITE 350
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City | ANNANDALE
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State | VA
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Zip | 22003-1275
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Country | US
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Telephone | 703-260-1179
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Fax | 703-260-1179
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | D0070737
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License Number State | MD
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Taxonomy #2
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Taxonomy Code | 207VC0200X
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Taxonomy Name | Critical Care Medicine (Obstetrics & Gynecology) Physician
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License Number | D0070737
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License Number State | MD
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Taxonomy #3
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0101252905
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License Number State | VA
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