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Individual

KELLIE BOBBITT SMALDORE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DO

Contact information

Practice address
2227 OLD EMMORTON RD STE 218, BEL AIR, MD 21015-6189
(443) 371-4940
(443) 371-4941
Mailing address
2227 OLD EMMORTON RD STE 218, BEL AIR, MD 21015-6189
(443) 371-4940
(443) 371-4941

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
H0040582
MD
207Q00000X
Family Medicine Physician
H40582
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
199L
MEDICARE GROUP
MD
05
348681800
MD
Enumeration date
09/08/2005
Last updated
02/08/2023
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