Individual
KEVIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
7250 JOPLIN ST, CAPITOL HEIGHTS, MD 20743-1817
(240) 396-8093
Mailing address
7250 JOPLIN ST, CAPITOL HEIGHTS, MD 20743-1817
(240) 396-8093
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
S-530-465-067-254
DRIVER'S LICENSE
MD
Enumeration date
02/15/2023
Last updated
02/15/2023
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