Individual
ELIZABETH THERESA SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
17978 SR 55, BAKER, WV 26801
(304) 897-5915
(304) 897-6216
Mailing address
PO BOX 281, OLD FIELDS, WV 26845-0281
(304) 538-6634
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
16642
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1558329763
NPI
—
05
—
1809357000
—
WV
Enumeration date
05/04/2006
Last updated
04/28/2015
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