# DR. MARK S SMITH

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1508953860
- **Gender:** Man
- **Credential:** DC PC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 111NN0400X | Neurology Chiropractor | 0104000196 | VA | Yes |

## Other

- **Enumeration date:** 10/06/2006
- **Last updated:** 10/27/2016

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 177764 | ANTHEM BC/BS ID | VA |
| 01 | — | 541182330 | AETNA PROVIDER ID | VA |