Provider Demographics
NPI:1558386383
Name:SMITH, NORMAN J (MD)
Entity Type:Individual
Prefix:
First Name:NORMAN
Middle Name:J
Last Name:SMITH
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:8741 LANDMARK RD
Mailing Address - Street 2:RMS
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23228-2801
Mailing Address - Country:US
Mailing Address - Phone:804-264-7605
Mailing Address - Fax:804-672-6899
Practice Address - Street 1:1870 AMHERST ST
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601
Practice Address - Country:US
Practice Address - Phone:540-722-8912
Practice Address - Fax:540-722-2635
Is Sole Proprietor?:No
Enumeration Date:2006-07-13
Last Update Date:2008-04-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA01010216942085R0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0001XAllopathic & Osteopathic PhysiciansRadiologyRadiation Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA7231067Medicaid
VA7231067Medicaid