Individual
EDWIN A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5445 MERIDIAN MARKS RD NE, SUITE 420, ATLANTA, GA 30342-4763
(404) 252-5206
(404) 252-1268
Mailing address
1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 284-4040
(678) 284-4076
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
034246
GA
2088P0231X
Pediatric Urology Physician
Primary
034246
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000694999B
—
GA
01
—
340014353
RAILROAD MEDICARE
GA
05
—
Q34246
—
SC
Enumeration date
08/13/2006
Last updated
03/07/2023
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