Individual
RUSSELL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RN., FNP
Contact information
Practice address
1230 BAY DALE DR, ARNOLD, MD 21012-2325
(410) 757-0027
Mailing address
2440 LIZBEC CT, CROFTON, MD 21114-3246
(301) 801-6725
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R182595
MD
Other
Enumeration date
11/07/2016
Last updated
11/07/2016
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