Provider Demographics
NPI:1477194918
Name:SMITH, TOMEKA CAMILE
Entity Type:Individual
Prefix:
First Name:TOMEKA
Middle Name:CAMILE
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:301 TINGEY ST SE APT 112
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-4610
Mailing Address - Country:US
Mailing Address - Phone:202-680-4630
Mailing Address - Fax:
Practice Address - Street 1:461 H ST NW APT 214
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20001-4732
Practice Address - Country:US
Practice Address - Phone:202-813-7699
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-07
Last Update Date:2019-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC32777313747P1801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant