MEDICARE: EMMANUEL ADEMOLA 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
1	208D00000X	General Practice Physician	MD066013L	PA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1147631	OTHER	PA	AETNA
2	30027672	OTHER	PA	KEYSTONE MERCY
3	36420MD066013L	OTHER	PA	HEALTH PARTNERS
4	2678918000	OTHER	PA	KEYSTONE HP/PC
5	SM1821064	OTHER	PA	HIGHMARK BLUESHIELD

General Provider Information

NPI Number	:	1487688834
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMMANUEL ADEMOLA SMITH M.D.

Provider Business Mailing Address
First Line	:	3998 RED LION RD STE 214
Second Line	:
City	:	PHILADELPHIA
State	:	PA
Zip	:	19114-1440
Country	:	US
Telephone Number	:	215-612-4700
Fax Number	:

Provider Business Practice Location Address
First Line	:	261 MEETING HOUSE LN
Second Line	:
City	:	MERION STATION
State	:	PA
Zip	:	19066-1231
Country	:	US
Telephone Number	:	610-771-0290
Fax Number	:

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

Provider Enumeration Date	:	07/10/2006
Last Update Date	:	07/08/2007

Similar Medicare Providers

1043340441 — E. SMITH SURGICAL ASSOCIATE INC
Practice Location Address:

261 MEETING HOUSE LN
MERION STATION, PA
19066-1231

Practice Phone: 610-771-0290
Practice Fax:

1205282530 — HUNTINGTON COMMUNITY FIRST AID SQUAD INC.
Practice Location Address:

2 RAILROAD ST
HUNTINGTON STATION, NY
11746-1231

Practice Phone: 631-421-1263
Practice Fax: 631-421-8484

1730182858 — STANLEY ORKIN FORMAN MD
Practice Location Address:

40 OLD LANCASTER RD APT 412
MERION STATION, PA
19066

Practice Phone: 267-388-9763
Practice Fax:

1275505075 — MRS. PENNY J GOLDBERG M.S.S. L.C.S.W.
Practice Location Address:

508 PRESCOTT RD
MERION STATION, PA
19066-1041

Practice Phone: 610-667-0112
Practice Fax: 484-615-6080

1174598130 — DR. JAY S BONOVITZ
Practice Location Address:

214 DERWEN RD
MERION STATION, PA
19066-1207

Practice Phone: 610-664-3785
Practice Fax: 610-664-5647

1538135710 — MS. JOAN F POLLAK LCSW
Practice Location Address:

540 HAMILTON RD.
MERION STATION, PA
19066-1125

Practice Phone: 610-724-2829
Practice Fax: 610-617-3507

Directions to “ EMMANUEL ADEMOLA SMITH M.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2026 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.