Provider Demographics
NPI:1437188703
Name:DIABETES AND ENDOCRINOLOGY PA M SMITH
Entity Type:Organization
Organization Name:DIABETES AND ENDOCRINOLOGY PA M SMITH
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MUHAMMAD
Authorized Official - Middle Name:SUHAIL
Authorized Official - Last Name:SMITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:410-392-9026
Mailing Address - Street 1:303 LANDING LN
Mailing Address - Street 2:
Mailing Address - City:ELKTON
Mailing Address - State:MD
Mailing Address - Zip Code:21921-6613
Mailing Address - Country:US
Mailing Address - Phone:410-392-9026
Mailing Address - Fax:410-392-9024
Practice Address - Street 1:303 LANDING LN
Practice Address - Street 2:
Practice Address - City:ELKTON
Practice Address - State:MD
Practice Address - Zip Code:21921-6613
Practice Address - Country:US
Practice Address - Phone:410-392-9026
Practice Address - Fax:410-392-9024
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0052227207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & MetabolismGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDE237OtherFEDERAL BCBS PIN #
MD350914OtherMAMSI LIFE & HEALTH PIN #
DE0001001402Medicaid
MD0477461000OtherAMERIHEALTH PIN #
MDE237OtherCAREFIRST BLUECHOIC PIN #
MDLL44DIOtherBCBS PIN #
MD710656OtherPERSONAL CHOICE PIN #
MD=========OtherUNITED HEALTHCARE PIN #
MDE237OtherCAREFIRST BLUECHOIC PIN #
MD710656OtherPERSONAL CHOICE PIN #
MD=========OtherTAX ID
DE=========OtherBCBS PIN #
MD=========OtherCOVENTRY PIN #
MDE237OtherFEDERAL BCBS PIN #
MDLL44DIOtherBCBS PIN #
MD=========OtherUNITED HEALTHCARE PIN #