Individual
MR. KELLON SEAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
12500 WILLOWBROOK RD, CUMBERLAND, MD 21502-6393
(240) 964-3600
Mailing address
115 BALTIMORE ST, SUITE 200, CUMBERLAND, MD 21502-2301
(301) 723-4965
(301) 723-4809
Taxonomy
Speciality
Code
Description
License number
State
163WM0705X
Medical-Surgical Registered Nurse
Primary
R203959
MD
Other
Enumeration date
01/29/2013
Last updated
01/29/2013
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