Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 0101255371 | VA |
NPI | 1417160524 |
---|---|
Provider Name | Tovia Martirosian Smith |
First Address | Richmond, VA 23226-3754 |
Second Address | Mechanicsville, VA 23116-3818 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/05/2007 |
Last Update Date | 27/03/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1417160524 | (05) | VA |
VVC732A | MEDICARE PTAN (01) |