Provider Demographics
NPI:1376543504
Name:SMITH, CYNTHIA NASEEM AHMED (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:NASEEM AHMED
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:NASEEM
Other - Middle Name:AHMED
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:5500 S SYCAMORE ST
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80120-8201
Mailing Address - Country:US
Mailing Address - Phone:303-440-1340
Mailing Address - Fax:303-889-0838
Practice Address - Street 1:5500 S SYCAMORE ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80120-8201
Practice Address - Country:US
Practice Address - Phone:303-440-1340
Practice Address - Fax:303-889-0838
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-29
Last Update Date:2016-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO348432084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO79631347Medicaid
G66477Medicare UPIN