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NPI Code Detail

MEDICARE: ELLEN L SMITH MD

MEDICARE: ELLEN 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
1207P00000XEmergency Medicine PhysicianD0043536MD

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
20022OTHERCAREFIRST

General Provider Information

NPI Number : 1770572463
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELLEN L SMITH MD
Provider Business Mailing Address
First Line : 1300 PICCARD DR
Second Line : SUITE 202
City : ROCKVILLE
State : MD
Zip : 20850-4303
Country : US
Telephone Number : 301-921-7900
Fax Number : 301-921-7915
Provider Business Practice Location Address
First Line : 18101 PRINCE PHILIP DR
Second Line :
City : OLNEY
State : MD
Zip : 20832-1514
Country : US
Telephone Number : 301-774-8900
Fax Number : 301-570-8574
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2005
Last Update Date : 07/21/2022

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Directions to “ ELLEN L SMITH MD” Practice Location

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