Individual
TABATHIA A SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1500 N 28TH ST, EMERGENCY DEPT., RICHMOND, VA 23223-5332
(804) 225-1780
(804) 225-1705
Mailing address
38935 ANN ARBOR RD, CREDENTIALING DEPT, LIVONIA, MI 48150-3397
(888) 861-8740
(866) 250-6385
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0101055832
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
005834864
—
VA
05
—
005844231
—
VA
05
—
005844240
—
VA
05
—
005844673
—
VA
01
—
11196250
CAQH
—
Enumeration date
07/17/2006
Last updated
01/08/2014
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