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General NPI Number Information
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NPI Number | 1437212586
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Entity Type | Organization
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Legal Business Name | DAVID J SMITH MD PA
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Dates
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Enumeration Date | 12/19/2006
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Last Update Date | 01/14/2008
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Provider Practice Location Address
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Address Line | 4807 ATLANTIC AVE
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City | VENTNOR
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State | NJ
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Zip | 08406
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Country | US
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Telephone | 609-823-8488
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Fax | 609-823-1787
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Provider Business Mailing Address
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Address Line | 4807 ATLANTIC AVE
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City | VENTNOR
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State | NJ
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Zip | 08406
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Country | US
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Telephone | 609-823-8488
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Fax | 609-823-1787
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Authorized Official
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Title or Position | OWNER
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Name | DR. DAVID J SMITH
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Credential | MD
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Telephone | 609-823-8488
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | MD015011E
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number | 25MA02945300
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License Number State | NJ
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