Individual
ROBERTA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
333 COTTMAN AVE, PHILADELPHIA, PA 19111-2434
(215) 728-3675
Mailing address
2450 W HUNTING PARK AVE, PHILADELPHIA, PA 19129-1302
(215) 728-2040
(215) 728-2064
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
MD05004674L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0015097230005
—
PA
Enumeration date
04/18/2006
Last updated
04/12/2018
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