Individual
EMMANUEL ADEMOLA SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
261 MEETING HOUSE LN, MERION STATION, PA 19066-1231
(610) 771-0290
Mailing address
3998 RED LION RD STE 214, PHILADELPHIA, PA 19114-1440
(215) 612-4700
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
MD066013L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1147631
AETNA
PA
01
—
2678918000
KEYSTONE HP/PC
PA
01
—
30027672
KEYSTONE MERCY
PA
01
—
36420MD066013L
HEALTH PARTNERS
PA
01
—
SM1821064
HIGHMARK BLUESHIELD
PA
Enumeration date
07/10/2006
Last updated
07/08/2007
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