MEDICARE: MS. DARYA D SMOLIEVSKAYA C-AA

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	367H00000X	Anesthesiologist Assistant	592	WI

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	:	1912626979
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DARYA D SMOLIEVSKAYA C-AA

Provider Business Mailing Address
First Line	:	1606 MISSISSIPPI AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-2549
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1606 MISSISSIPPI AVE
Second Line	:
City	:	SAINT LOUIS
State	:	MO
Zip	:	63104-2549
Country	:	US
Telephone Number	:	904-352-4079
Fax Number	:

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

Provider Enumeration Date	:	08/24/2022
Last Update Date	:	02/23/2026

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