MEDICARE: NATAJIA SMITH

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	335E00000X	Prosthetic/Orthotic Supplier

General Provider Information

NPI Number	:	1245917277
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NATAJIA SMITH

Provider Business Mailing Address
First Line	:	7469 OLD ALEXANDRIA FERRY RD STE A
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-1834
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	7469 OLD ALEXANDRIA FERRY RD STE A
Second Line	:
City	:	CLINTON
State	:	MD
Zip	:	20735-1834
Country	:	US
Telephone Number	:	202-766-2481
Fax Number	:

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

Provider Enumeration Date	:	06/30/2023
Last Update Date	:	06/30/2023

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Directions to “ NATAJIA SMITH ” Practice Location

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