Provider Demographics
NPI:1528226750
Name:SMITH, ELIZABETH CORR ANDERSON (MD)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:CORR ANDERSON
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1305 POST RD
Mailing Address - Street 2:SUITE 310
Mailing Address - City:FAIRFIELD
Mailing Address - State:CT
Mailing Address - Zip Code:06824-6016
Mailing Address - Country:US
Mailing Address - Phone:203-259-7709
Mailing Address - Fax:
Practice Address - Street 1:1305 POST RD
Practice Address - Street 2:SUITE 310
Practice Address - City:FAIRFIELD
Practice Address - State:CT
Practice Address - Zip Code:06824-6016
Practice Address - Country:US
Practice Address - Phone:203-259-7709
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-23
Last Update Date:2013-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY243532-1207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology