Individual
GERRY NIEMAN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1120 FIRST COLONIAL RD STE 206, VIRGINIA BEACH, VA 23454-2418
(757) 496-2325
(757) 496-1942
Mailing address
548 ALLENS MILL RD, GRAFTON, VA 23692-2240
(757) 496-2325
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
0101049815
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1215991377
—
VA
01
—
400020904
IRS
VA
Enumeration date
04/14/2006
Last updated
03/06/2023
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