Organization
BLUE RIDGE INTERNAL MEDICINE INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TODD ANDREW SMITH DO (PRESIDENT)
(304) 487-0232
Entity
Organization
Contact information
Practice address
407 12TH STREET EXT, PRINCETON, WV 24740-2300
(304) 487-0232
(304) 487-0285
Mailing address
PO BOX 5065, PRINCETON, WV 24740-5065
(304) 487-0232
(304) 487-0285
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
1804
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3810003706
—
WV
Enumeration date
10/04/2006
Last updated
07/10/2008
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