Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207P00000X | Emergency Physician | D0052950 | MD |
N | 207P00000X | Emergency Physician | ME114831 | FL |
Y | 207RC0200X | Critical Care Medicine | ME114831 | FL |
N | 2086S0102X | Surgical Critical Care | D0052950 | MD |
NPI | 1205816899 |
---|---|
Provider Name | Dr. Lamont Charles Smith |
First Address | Ellicott City, MD 21042-1851 |
Second Address | Baltimore, MD 21201-1544 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/01/2006 |
Last Update Date | 14/06/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
171100800 | (05) | MD |
61449712 | CAREFIRST BCBS (01) | MD |
74960004 | CAREFIRST BCBS (01) | DC |