Provider Demographics
NPI:1952040990
Name:SMITH, DARSHAL (CERTIFIED DOULA)
Entity Type:Individual
Prefix:
First Name:DARSHAL
Middle Name:
Last Name:SMITH
Suffix:
Gender:F
Credentials:CERTIFIED DOULA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11309 MAIDEN DR
Mailing Address - Street 2:
Mailing Address - City:BOWIE
Mailing Address - State:MD
Mailing Address - Zip Code:20720-3571
Mailing Address - Country:US
Mailing Address - Phone:240-687-7010
Mailing Address - Fax:
Practice Address - Street 1:11309 MAIDEN DR
Practice Address - Street 2:
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20720-3571
Practice Address - Country:US
Practice Address - Phone:240-687-7010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-05-28
Last Update Date:2022-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD19080917041932Medicaid