Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | 035765 | GA |
N | 207RC0000X | Internist - Cardiovascular Disease | 035765 | GA |
NPI | 1760492110 |
---|---|
Provider Name | Andrew L Smith |
First Address | Atlanta, GA 30322-1013 |
Second Address | Atlanta, GA 30322-1013 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 22/08/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E13036 | (02) | GA |