MEDICARE: ANDREW L SMITH MD

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	207RC0000X	Cardiovascular Disease Physician	035765	GA
2	207RA0001X	Advanced Heart Failure and Transplant Cardiology Physician	035765	GA

General Provider Information

NPI Number	:	1760492110
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ANDREW L SMITH MD

Provider Business Mailing Address
First Line	:	1365 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1013
Country	:	US
Telephone Number	:	404-778-5299
Fax Number	:

Provider Business Practice Location Address
First Line	:	1365 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-1013
Country	:	US
Telephone Number	:	404-778-5299
Fax Number	:

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

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	08/22/2017

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