Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 12904 | DC |
NPI | 1013188143 |
---|---|
Provider Name | Dr. Deborah Martina Smith |
First Address | Washington, DC 20009 |
Second Address | Washington, DC 20009-4308 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 17/03/2008 |
Last Update Date | 17/03/2008 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
C89067 | (02) | DC |