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Organization

E. SMITH SURGICAL ASSOCIATE INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. EMMANUEL ADEMOLA SMITH M.D. (OWNER)
(215) 612-4700
Entity
Organization

Contact information

Practice address
261 MEETING HOUSE LN, MERION STATION, PA 19066-1231
(610) 771-0290
Mailing address
3998 RED LION RD, SUITE 306, PHILADELPHIA, PA 19114-1441
(215) 612-2652

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD 066013-L
PA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0764657000
KEYSTON HP EAST
PA
01
1147631
AETNA
PA
01
30027672
KEYSTONE MERCY
PA
01
36420MD066013L
HEALTH PARTNERS
PW
01
SM1821064
HIGH MARK BLUE SHIELD
PA
Enumeration date
03/06/2007
Last updated
11/14/2007
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