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General NPI Number Information
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NPI Number | 1841350915
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Entity Type | Individual
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Provider Name | RAFAL MAREK SMIGRODZKI MD
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Gender | Male
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 06/06/2025
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Provider Practice Location Address
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Address Line | 7050 GLENHAVEN RIDGE DR
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City | CLEMMONS
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State | NC
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Zip | 27012-8981
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Country | US
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Telephone | 434-249-4381
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Fax | 940-301-3881
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Provider Business Mailing Address
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Address Line | 7050 GLENHAVEN RIDGE DR
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City | CLEMMONS
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State | NC
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Zip | 27012-8981
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Country | US
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Telephone | 434-249-4381
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Fax | 940-301-3881
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2014-01922
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License Number State | NC
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 9899
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License Number State | ND
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