Individual
AMANDA ELIZABETH SMART
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
19415 DEERFIELD AVENUE, SUITE 112, LEESBURG, VA 20176-8470
(703) 724-1195
(703) 724-4495
Mailing address
224-D CORNWALL STREET NW, SUITE 403, LEESBURG, VA 20176-2704
(703) 737-6010
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
0101279969
VA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
30018093910001
—
VA
Enumeration date
04/05/2019
Last updated
04/08/2025
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