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NPI Code Detail

MEDICARE: MRS. ANNE M SMITH RD

MEDICARE:  MRS. ANNE M SMITH  RD
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
1133V00000XRegistered DietitianD01421MD

General Provider Information

NPI Number : 1477195444
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. ANNE M SMITH RD
Provider Business Mailing Address
First Line : 5005 SIGNAL BELL LN STE 201
Second Line :
City : CLARKSVILLE
State : MD
Zip : 21029-2608
Country : US
Telephone Number : 410-730-3399
Fax Number : 443-478-4726
Provider Business Practice Location Address
First Line : 8186 LARK BROWN RD STE 201-202
Second Line :
City : ELKRIDGE
State : MD
Zip : 21075-6433
Country : US
Telephone Number : 410-730-3399
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/11/2019
Last Update Date : 10/11/2019

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Directions to “ MRS. ANNE M SMITH RD” Practice Location

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