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General NPI Number Information
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NPI Number | 1639101520
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Entity Type | Individual
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Provider Name | GREGORY A SMITH DPM
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Gender | Male
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Dates
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Enumeration Date | 07/07/2006
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Last Update Date | 11/28/2018
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Provider Practice Location Address
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Address Line | 11110 MEDICAL CAMPUS RD SUITE 100
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City | HAGERSTOWN
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State | MD
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Zip | 21742
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Country | US
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Telephone | 301-739-1575
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Fax | 301-739-1578
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Provider Business Mailing Address
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Address Line | 11110 MEDICAL CAMPUS RD SUITE 100
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City | HAGERSTOWN
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State | MD
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Zip | 21742
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Country | US
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Telephone | 301-739-1575
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Fax | 301-739-1578
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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 | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | 00653
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License Number State | MD
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