Provider Demographics
NPI:1629114228
Name:SMITH, LORIE BENTON (MD, MHS)
Entity Type:Individual
Prefix:DR
First Name:LORIE
Middle Name:BENTON
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD, MHS
Other - Prefix:DR
Other - First Name:LORIE
Other - Middle Name:LEIGH
Other - Last Name:BENTON-SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:8901 WISCONSIN AVE
Mailing Address - Street 2:HFM 486, SUITE 370 N
Mailing Address - City:BETHESDA
Mailing Address - State:MD
Mailing Address - Zip Code:20889-0004
Mailing Address - Country:US
Mailing Address - Phone:301-400-1769
Mailing Address - Fax:
Practice Address - Street 1:8901 WISCONSIN AVE
Practice Address - Street 2:NNMC, SECTION OF PEDIATRIC NEPHROLOGY
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20889-0001
Practice Address - Country:US
Practice Address - Phone:301-295-4941
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-30
Last Update Date:2016-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD706142080P0210X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology