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General NPI Number Information
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NPI Number | 1558672006
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Entity Type | Organization
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Legal Business Name | JOAN SMITH, D.O. P.A.
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Dates
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Enumeration Date | 06/30/2010
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Last Update Date | 07/13/2010
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Provider Practice Location Address
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Address Line | 31664 OLD OCEAN CITY RD
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City | SALISBURY
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State | MD
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Zip | 21804-1800
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Country | US
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Telephone | 410-334-3805
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Fax | 410-860-5191
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Provider Business Mailing Address
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Address Line | 31664 OLD OCEAN CITY RD
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City | SALISBURY
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State | MD
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Zip | 21804-1800
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Country | US
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Telephone | 410-334-3805
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Fax | 410-860-5191
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Authorized Official
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Title or Position | PHYSICIAN
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Name | JOAN SMITH
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Credential | D.O.
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Telephone | 410-334-3805
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | H0048286
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License Number State | MD
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