Provider Demographics
NPI:1013188143
Name:SMITH, DEBORAH MARTINA (MD)
Entity Type:Individual
Prefix:DR
First Name:DEBORAH
Middle Name:MARTINA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1407 S STREET, NW
Mailing Address - Street 2:WHITMAN-WALKER CLINIC
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20009
Mailing Address - Country:US
Mailing Address - Phone:202-797-3507
Mailing Address - Fax:202-797-4431
Practice Address - Street 1:1701 14TH ST NW
Practice Address - Street 2:ELIZABETH TAYLOR MEDICAL CENTER
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20009-4308
Practice Address - Country:US
Practice Address - Phone:202-745-7000
Practice Address - Fax:202-745-0238
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-17
Last Update Date:2008-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC12904207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
DCC89067Medicare UPIN