Provider Demographics
NPI:1265611230
Name:HO, SMITH (MD)
Entity type:Individual
Prefix:DR
First Name:SMITH
Middle Name:
Last Name:HO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:7610 CARROLL AVE
Mailing Address - Street 2:SUITE 280
Mailing Address - City:TAKOMA PARK
Mailing Address - State:MD
Mailing Address - Zip Code:20912-6384
Mailing Address - Country:US
Mailing Address - Phone:301-891-6100
Mailing Address - Fax:301-891-5836
Practice Address - Street 1:7610 CARROLL AVE
Practice Address - Street 2:SUITE 280
Practice Address - City:TAKOMA PARK
Practice Address - State:MD
Practice Address - Zip Code:20912-6384
Practice Address - Country:US
Practice Address - Phone:301-891-6100
Practice Address - Fax:301-891-5836
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-26
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MD002195018207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD187631700Medicaid
DC131890Medicare PIN
MD187631700Medicaid