Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0202X | Pediatric Cardiologist | 35-057808 | OH |
N | 2080P0202X | Pediatric Cardiologist | MD045269L | PA |
NPI | 1285794529 |
---|---|
Provider Name | Grace L. Smith |
First Address | Akron, OH 44308-1063 |
Second Address | Boardman, OH 44512-3457 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2006 |
Last Update Date | 30/03/2021 |