Organization
LANDMARK MEDICAL GROUP LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CLARENCE SMITH JR. M.D. (PRESIDENT)
(410) 638-5101
Entity
Organization
Contact information
Practice address
615 W MACPHAIL RD, SUITE 206, BEL AIR, MD 21014-4309
(410) 638-5101
(410) 638-6854
Mailing address
PO BOX 667, BEL AIR, MD 21014-0667
(410) 638-5101
(410) 638-6854
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
MD
207R00000X
Internal Medicine Physician
Primary
—
MD
208000000X
Pediatrics Physician
—
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
968102701
—
MD
01
—
LN93
CAREFIRST BC/BS
MD
Enumeration date
02/21/2006
Last updated
10/22/2015
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