Provider Demographics
NPI:1821047192
Name:SMITH, LINDA MARIE (MD)
Entity Type:Individual
Prefix:DR
First Name:LINDA
Middle Name:MARIE
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 1:514 SOUTH ST STE 3
Mailing Address - Street 2:
Mailing Address - City:BOW
Mailing Address - State:NH
Mailing Address - Zip Code:03304-3419
Mailing Address - Country:US
Mailing Address - Phone:603-333-2384
Mailing Address - Fax:
Practice Address - Street 1:514 SOUTH ST
Practice Address - Street 2:STE 3
Practice Address - City:BOW
Practice Address - State:NH
Practice Address - Zip Code:03304-3419
Practice Address - Country:US
Practice Address - Phone:603-333-2384
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-06
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA81023207Q00000X
ORMD171858207Q00000X
NH21251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR93-0635514OtherNORTH BEND MEDICAL CENTER GROUP TAX ID
OR1407812365OtherNORTH BEND MEDICAL CENTER GROUP NPI
OR500687896Medicaid
ORR0000WFBTVOtherNORTH BEND MEDICAL CENTER GROUP MEDICARE
OR161133OtherNORTH BEND MEDICAL CENTER GROUP MEDICAID
OR500687896Medicaid