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General NPI Number Information
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NPI Number | 1336567353
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Entity Type | Individual
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Provider Name | KATHERINE SMENTKOWSKI
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Gender | Female
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Dates
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Enumeration Date | 04/07/2014
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Last Update Date | 10/19/2020
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Provider Practice Location Address
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Address Line | 10710 CHARTER DR STE 130
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City | COLUMBIA
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State | MD
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Zip | 21044-3258
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Country | US
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Telephone | 800-953-3111
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Fax |
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Provider Business Mailing Address
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Address Line | 25 CROSSROADS DR STE 306
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City | OWINGS MILLS
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State | MD
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Zip | 21117-5437
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Country | US
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Telephone | 800-953-3111
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Fax |
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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 | 208800000X
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Taxonomy Name | Urology Physician
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License Number | MD467006
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | D0088819
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License Number State | MD
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