Individual
JACQUELINE A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
424 SAVANNAH RD, LEWES, DE 19958-1462
(302) 645-3554
Mailing address
4 MELODY CT, REHOBOTH BEACH, DE 19971-8600
(703) 346-4235
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
C1-0011839
DE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005884314
—
VA
05
—
1245213651
—
VA
Enumeration date
11/21/2005
Last updated
12/21/2016
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