Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RH0003X | Hematology & Oncology | MD459561 | PA |
NPI | 1063788495 |
---|---|
Provider Name | Chad Smith |
First Address | New Castle, PA 16105-3210 |
Second Address | New Castle, PA 16105-3210 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2012 |
Last Update Date | 20/10/2021 |