MEDICARE: EDWARD R. SMITH JR. 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
1	207PE0004X	Emergency Medical Services (Emergency Medicine) Physician	MD34019	DC
2	207P00000X	Emergency Medicine Physician	MD 34019	DC

General Provider Information

NPI Number	:	1225100696
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EDWARD R. SMITH JR. M.D.

Provider Business Mailing Address
First Line	:	2150 PENNSYLVANIA AVE NW
Second Line	:
City	:	WASHINGTON
State	:	DC
Zip	:	20037-3201
Country	:	US
Telephone Number	:	202-715-4911
Fax Number	:	202-741-3396

Provider Business Practice Location Address
First Line	:	2100 CLARENDON BLVD STE 400
Second Line	:
City	:	ARLINGTON
State	:	VA
Zip	:	22201-5445
Country	:	US
Telephone Number	:	202-258-6510
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/14/2006
Last Update Date	:	03/02/2026

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