Individual
DR. TAMARA SUSAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
14535 JOHN MARSHALL HWY, SUITE 212, GAINESVILLE, VA 20155-4025
(571) 248-0245
(571) 248-0241
Mailing address
224 D CORNWALL STREET NW, STE 403, LEESBURG, VA 20176-2704
(703) 737-6010
(703) 443-8643
Taxonomy
Speciality
Code
Description
License number
State
207K00000X
Allergy & Immunology Physician
Primary
0101243112
VA
207R00000X
Internal Medicine Physician
0101243112
VA
207R00000X
Internal Medicine Physician
21653
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1225127129
—
VA
05
—
30016040950001
—
VA
Enumeration date
10/11/2006
Last updated
03/19/2024
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