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General NPI Number Information
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NPI Number | 1699913814
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Entity Type | Organization
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Legal Business Name | ELLIECE S. SMITH, M.D., P.C.
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Dates
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Enumeration Date | 01/26/2009
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Last Update Date | 09/08/2009
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Provider Practice Location Address
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Address Line | 9470 ANNAPOLIS RD SUITE 316
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City | LANHAM
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State | MD
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Zip | 20706-3025
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Country | US
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Telephone | 301-459-5744
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Fax | 301-459-5784
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Provider Business Mailing Address
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Address Line | 9470 ANNAPOLIS RD SUITE 316
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City | LANHAM
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State | MD
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Zip | 20706-3025
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Country | US
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Telephone | 301-459-5744
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Fax | 301-459-5784
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ELLIECE S. SMITH
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Credential | M.D.
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Telephone | 301-459-5744
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | D0021988
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License Number State | MD
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