Provider Demographics
NPI:1396932612
Name:SMOLA, ELIZABETH M (MD)
Entity type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:M
Last Name:SMOLA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:ELIZABETH
Other - Middle Name:MORTARELLI
Other - Last Name:SMOLA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD,
Mailing Address - Street 1:1529 DUNHAMTOWN BRIMFIELD ROAD
Mailing Address - Street 2:
Mailing Address - City:BRIMFIELD
Mailing Address - State:MA
Mailing Address - Zip Code:01010
Mailing Address - Country:US
Mailing Address - Phone:413-245-6234
Mailing Address - Fax:
Practice Address - Street 1:1529 DUNHAMTOWN BRIMFIELD ROAD
Practice Address - Street 2:
Practice Address - City:BRIMFIELD
Practice Address - State:MA
Practice Address - Zip Code:01010
Practice Address - Country:US
Practice Address - Phone:413-245-6234
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-01
Last Update Date:2009-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA42942207P00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine