Individual
DIANE E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
100 KENYON AVE, WAKEFIELD, RI 02879-4216
(401) 782-8000
Mailing address
140 HOSPITAL DR, SUITE 108, BENNINGTON, VT 05201-5009
(802) 447-5519
(802) 447-5657
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
0420013392
VT
207R00000X
Internal Medicine Physician
042212
CT
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
MD09423
RI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1026765
—
VT
01
—
U400473648
MEDICARE
RI
Enumeration date
12/28/2005
Last updated
06/08/2018
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