Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 0103001054 | VA |
Y | 222Z00000X | Podiatrist | 0103001054 | VA |
N | 213EP0504X | Public Medicine | 0103001054 | VA |
N | 213EP1101X | Primary Podiatric Medicine | 0103001054 | VA |
N | 2081S0010X | Sports Medicine | 0103001054 | VA |
N | 213ES0000X | Sports Medicine | 0103001054 | VA |
NPI | 1457447864 |
---|---|
Provider Name | Dr. Joseph Giro Smith |
First Address | Virginia Beach, VA 23462 |
Second Address | Virginia Beach, VA 23462 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/10/2006 |
Last Update Date | 12/07/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
009304533 | (05) | VA |
384612 | ANTHEM-BLUE CROSS (01) | VA |
U74490 | (02) | VA |