Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080N0001X | Neonatal-Perinatal Doctor | D0078130 | MD |
NPI | 1013323096 |
---|---|
Provider Name | Kimberly Remedios-Smith |
First Address | Baltimore, MD 21224-2735 |
Second Address | Rockford, IL 61103-3655 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/07/2014 |
Last Update Date | 22/12/2016 |