Provider Demographics
NPI:1326239575
Name:SMITH, MARY NANNA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:NANNA
Last Name:SMITH
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Gender:F
Credentials:MD
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Mailing Address - Street 1:3299 WOODBURN RD
Mailing Address - Street 2:SUITE 350
Mailing Address - City:ANNANDALE
Mailing Address - State:VA
Mailing Address - Zip Code:22003-1275
Mailing Address - Country:US
Mailing Address - Phone:703-260-1179
Mailing Address - Fax:703-260-1179
Practice Address - Street 1:2000 MEDICAL PKWY
Practice Address - Street 2:SUITE 304
Practice Address - City:ANNAPOLIS
Practice Address - State:MD
Practice Address - Zip Code:21401-3742
Practice Address - Country:US
Practice Address - Phone:410-573-9530
Practice Address - Fax:410-573-9569
Is Sole Proprietor?:No
Enumeration Date:2007-08-05
Last Update Date:2013-05-14
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Provider Licenses
StateLicense IDTaxonomies
MDD0070737207V00000X, 207VC0200X
VA0101252905207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No207VC0200XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyCritical Care Medicine