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Individual

DAREN EDWARD SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6204 PLANK RD, FREDERICKSBURG, VA 22407-6238
(540) 507-7966
Mailing address
503 MAPLE GROVE DR, FREDERICKSBURG, VA 22407-8917
(540) 270-5588

Taxonomy

Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
146N00000X
Basic Emergency Medical Technician
Primary
B201400319
VA
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
B201400319
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
B201400319
VIRGINIA OFFICE OF EMERGENCY MEDICAL SERVICES
VA
Enumeration date
01/01/2018
Last updated
01/01/2018
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