Provider Demographics
NPI:1184893216
Name:SMIDT, AIMEE CAROLINE (MD)
Entity type:Individual
Prefix:DR
First Name:AIMEE
Middle Name:CAROLINE
Last Name:SMIDT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:AIMEE
Other - Middle Name:CAROLINE
Other - Last Name:HAWROT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:800 BRADBURY DR SE STE 116
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87106-4310
Mailing Address - Country:US
Mailing Address - Phone:505-272-1476
Mailing Address - Fax:505-272-8060
Practice Address - Street 1:UNIVERSITY OF NEW MEXICO DEPT OF DERMATOLOGY
Practice Address - Street 2:1021 MEDICAL ARTS AVE NE
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-6000
Practice Address - Fax:505-272-6003
Is Sole Proprietor?:No
Enumeration Date:2008-02-22
Last Update Date:2024-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMMD2009-0548207NP0225X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207NP0225XAllopathic & Osteopathic PhysiciansDermatologyPediatric Dermatology