Individual
MARA S SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
121 CORPORATE DRIVE, SUITE 200, PORTSMOUTH, NH 03801
(603) 610-8092
Mailing address
789 CENTRAL AVE, DOVER, NH 03820-2526
(603) 610-8092
(603) 610-8096
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
0392P
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3083043
—
NH
Enumeration date
09/26/2005
Last updated
06/03/2019
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