Provider Demographics
NPI:1225083959
Name:SMITH, BARBARA H (MD)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:H
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 1:22 WHEEL WRIGHT CT
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27455-3446
Mailing Address - Country:US
Mailing Address - Phone:336-545-3064
Mailing Address - Fax:336-545-8749
Practice Address - Street 1:2307 W CONE BLVD
Practice Address - Street 2:STE 130
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-4027
Practice Address - Country:US
Practice Address - Phone:336-545-3064
Practice Address - Fax:336-545-8749
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-23
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC29200174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCE39711Medicare UPIN
NC2180229DMedicare ID - Type Unspecified