Provider Demographics
NPI:1811093636
Name:SMITH, GAYLE SCHRIER (MD)
Entity type:Individual
Prefix:
First Name:GAYLE
Middle Name:SCHRIER
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:7110 FOREST AVE
Mailing Address - Street 2:SUITE 105
Mailing Address - City:RICHMOND
Mailing Address - State:VA
Mailing Address - Zip Code:23226-3786
Mailing Address - Country:US
Mailing Address - Phone:804-377-7100
Mailing Address - Fax:804-377-8511
Practice Address - Street 1:7110 FOREST AVE
Practice Address - Street 2:SUITE 105
Practice Address - City:RICHMOND
Practice Address - State:VA
Practice Address - Zip Code:23226-3786
Practice Address - Country:US
Practice Address - Phone:804-377-7100
Practice Address - Fax:804-377-8511
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2014-10-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
VA0101049312208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
F85083Medicare UPIN
VA010000777Medicare ID - Type Unspecified