Individual
MS. ELAINE MARIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.-C
Contact information
Practice address
17978 SR 55, BAKER, WV 26801
(304) 897-5915
Mailing address
PO BOX 97, BAKER, WV 26801-0097
(304) 897-5915
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2041
WV
Other
Enumeration date
01/03/2017
Last updated
09/25/2024
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