Provider Demographics
NPI:1821215567
Name:SMITH, AMY MILLER (MD)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:MILLER
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:REBECCA
Other - Last Name:MILLER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:100 E LANCASTER AVE
Mailing Address - Street 2:LANKENAU HOSPITAL MOB EAST SUITE 450
Mailing Address - City:WYNNEWOOD
Mailing Address - State:PA
Mailing Address - Zip Code:19096-3450
Mailing Address - Country:US
Mailing Address - Phone:610-896-0648
Mailing Address - Fax:610-642-1690
Practice Address - Street 1:100 E LANCASTER AVE
Practice Address - Street 2:LANKENAU MOB EAST SUITE 450
Practice Address - City:WYNNEWOOD
Practice Address - State:PA
Practice Address - Zip Code:19096-3450
Practice Address - Country:US
Practice Address - Phone:610-896-0648
Practice Address - Fax:610-642-1690
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2017-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD431430207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine