Individual
SUSAN SMITH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
89 SUMMERS WAY, ROANOKE, VA 24019-8291
(540) 992-1251
Mailing address
6305 HAMLET TRL, ROANOKE, VA 24018-7790
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101-058352
VA
Other
Enumeration date
02/13/2006
Last updated
07/08/2007
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