Provider Demographics
NPI:1932481348
Name:SMITA P. MENGERS, MD
Entity Type:Organization
Organization Name:SMITA P. MENGERS, MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SMITA
Authorized Official - Middle Name:P
Authorized Official - Last Name:MENGERS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:301-540-7496
Mailing Address - Street 1:19803 EXECUTIVE PARK CIR
Mailing Address - Street 2:
Mailing Address - City:GERMANTOWN
Mailing Address - State:MD
Mailing Address - Zip Code:20874-2649
Mailing Address - Country:US
Mailing Address - Phone:301-540-7496
Mailing Address - Fax:301-540-0772
Practice Address - Street 1:19803 EXECUTIVE PARK CIR
Practice Address - Street 2:
Practice Address - City:GERMANTOWN
Practice Address - State:MD
Practice Address - Zip Code:20874-2649
Practice Address - Country:US
Practice Address - Phone:301-540-7496
Practice Address - Fax:301-540-0772
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-12
Last Update Date:2011-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty