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General NPI Number Information
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NPI Number | 1629538228
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Entity Type | Individual
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Provider Name | BENJAMIN FRANKLIN SMOOD MD
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Gender | Male
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Dates
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Enumeration Date | 03/21/2019
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Last Update Date | 07/21/2019
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Provider Practice Location Address
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Address Line | 3400 SPRUCE STREET, 4 MALONEY DEPARTMENT OF SURGERY, SURGERY EDUCATION
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City | PHILADELPHIA
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State | PA
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Zip | 19104
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Country | US
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Telephone | 503-537-7653
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Fax |
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Provider Business Mailing Address
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Address Line | 201 S 25TH ST APT 614
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City | PHILADELPHIA
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State | PA
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Zip | 19103-6008
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Country | US
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Telephone | 503-537-7653
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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 | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | MT218929
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License Number State | PA
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