Provider Demographics
NPI:1295028538
Name:SMITH, HUGH ANTHONY
Entity Type:Individual
Prefix:
First Name:HUGH
Middle Name:ANTHONY
Last Name:SMITH
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1121 VANGUARD WAY
Mailing Address - Street 2:APT F
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21015-4672
Mailing Address - Country:US
Mailing Address - Phone:441-371-7361
Mailing Address - Fax:
Practice Address - Street 1:6402 GOLDEN RING RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21237-2010
Practice Address - Country:US
Practice Address - Phone:410-866-2500
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-19
Last Update Date:2011-05-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD20061183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist