Individual
DR. WALLY R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1250 EAST MARSHALL STREET, INTERNAL MEDICINE, RICHMOND, VA 23298-0510
(804) 828-9690
(804) 828-5566
Mailing address
PO BOX 91734, RICHMOND, VA 23291-1734
(804) 358-6100
(804) 342-7619
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
0101047072
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006049061 541581185
—
VA
Enumeration date
10/12/2006
Last updated
02/28/2008
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