Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | MD040020E | PA |
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | C10010223 | DE |
NPI | 1184706533 |
---|---|
Provider Name | Dr. Angela Dorman Smith |
First Address | Rockland, DE 19732-0191 |
Second Address | Wilmington, DE 19803-3607 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/10/2006 |
Last Update Date | 27/03/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
001755502 | (05) | PA |
B73807 | (02) | PA |