MEDICARE: MR. WILLIAM CHARLES SMITH PT

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	2251X0800X	Orthopedic Physical Therapist	16911	MD

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	650020354	OTHER	MD	RAILROAD MEDICARE

Other Identifiers

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

General Provider Information

NPI Number	:	1396745469
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. WILLIAM CHARLES SMITH PT

Provider Business Mailing Address
First Line	:	807A S UNION AVE
Second Line	:
City	:	HAVRE DE GRACE
State	:	MD
Zip	:	21078-3610
Country	:	US
Telephone Number	:	410-939-2262
Fax Number	:	410-939-7119

Provider Business Practice Location Address
First Line	:	807A S UNION AVE
Second Line	:
City	:	HAVRE DE GRACE
State	:	MD
Zip	:	21078-3610
Country	:	US
Telephone Number	:	410-939-2262
Fax Number	:	410-939-7119

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

Provider Enumeration Date	:	07/29/2005
Last Update Date	:	09/23/2011

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Directions to “ MR. WILLIAM CHARLES SMITH PT” Practice Location

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