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NPI Code Detail

MEDICARE: MARIE C SMITH M.D,

MEDICARE: MARIE C SMITH M.D,
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207V00000XObstetrics & Gynecology Physician30167SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1104827807
Entity Type Code : Individual
Provider Name (Legal Business Name) : MARIE C SMITH M.D,
Provider Business Mailing Address
First Line : 100 N ACADEMY AVE
Second Line :
City : DANVILLE
State : PA
Zip : 17822-4903
Country : US
Telephone Number : 570-271-6144
Fax Number : 570-271-6578
Provider Business Practice Location Address
First Line : 400 HIGHLAND AVE
Second Line :
City : LEWISTOWN
State : PA
Zip : 17044-1167
Country : US
Telephone Number : 717-242-4200
Fax Number : 717-242-4212
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/03/2005
Last Update Date : 08/31/2020

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