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Individual

EDWARD PAUL SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
190 CAMPUS BLVD, SUITE 200, WINCHESTER, VA 22601-2872
(540) 662-6135
(540) 662-5845
Mailing address
190 CAMPUS BLVD, SUITE 200, WINCHESTER, VA 22601-2872
(540) 662-6135
(540) 662-5845

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101047458
VA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000613355
WV BLUE SHIELD
WV
01
08250500000
QUALCHOICE PROFESSIONAL
01
43939
SENTARA PROFESSIONAL
01
C00085
VA MEDICARE GROUP
VA
Enumeration date
04/25/2006
Last updated
03/05/2021
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