Provider Demographics
NPI:1326351776
Name:SMITH, GEORGE I (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:I
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:75 THOMAS JOHNSON DR
Mailing Address - Street 2:SUITE F
Mailing Address - City:FREDERICK
Mailing Address - State:MD
Mailing Address - Zip Code:21702-4895
Mailing Address - Country:US
Mailing Address - Phone:301-631-3674
Mailing Address - Fax:301-631-3675
Practice Address - Street 1:75 THOMAS JOHNSON DR
Practice Address - Street 2:SUITE F
Practice Address - City:FREDERICK
Practice Address - State:MD
Practice Address - Zip Code:21702-4895
Practice Address - Country:US
Practice Address - Phone:301-631-3674
Practice Address - Fax:301-631-3675
Is Sole Proprietor?:No
Enumeration Date:2010-07-14
Last Update Date:2010-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD10587207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine