Provider Demographics
NPI:1457447864
Name:SMITH, JOSEPH GIRO (DPM)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:GIRO
Last Name:SMITH
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4620 BUNKER HILL LANE
Mailing Address - Street 2:
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462
Mailing Address - Country:US
Mailing Address - Phone:757-499-8098
Mailing Address - Fax:757-499-8098
Practice Address - Street 1:4620 BUNKER HILL LANE
Practice Address - Street 2:
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462
Practice Address - Country:US
Practice Address - Phone:757-499-8098
Practice Address - Fax:757-499-8098
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0103001054213E00000X, 213EP0504X, 213EP1101X, 213ES0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
No213EP0504XPodiatric Medicine & Surgery Service ProvidersPodiatristPublic Medicine
No213EP1101XPodiatric Medicine & Surgery Service ProvidersPodiatristPrimary Podiatric Medicine
No213ES0000XPodiatric Medicine & Surgery Service ProvidersPodiatristSports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA384612OtherANTHEM-BLUE CROSS
VA009304533Medicaid
VA009304533Medicaid
VA480000626Medicare ID - Type UnspecifiedPODIATRY