Individual
STEPHEN M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8700 SUDLEY RD, MANASSAS, VA 20110-4418
(240) 686-2300
Mailing address
12420 MILESTONE CENTER DR STE 200, GERMANTOWN, MD 20876-7111
(240) 686-2300
(240) 686-2330
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101655831
VA
207P00000X
Emergency Medicine Physician
D0045203
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0009
CAREFIRST
—
05
—
14211500
—
MD
01
—
568L865C
MEDICARE
MD
Enumeration date
10/11/2005
Last updated
11/09/2021
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