Individual
DR. STACY E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
75 FRANCIS ST, RADIOLOGY BRIGHAM AND WOMEN'S HOSPITAL, BOSTON, MA 02115-6110
(617) 732-7537
(617) 525-7333
Mailing address
75 FRANCIS ST, RADIOLOGY BRIGHAM AND WOMEN'S HOSPITAL, BOSTON, MA 02115-6110
(617) 732-7537
(617) 525-7333
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
D0054137
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110800000
—
MD
01
—
38110031
CAREFIRST BCBS
DC
01
—
5235541
AETNA PPO
MD
01
—
967707
AETNA HMO
MD
01
—
KC46SH69762202
CAREFIRST BCBS
MD
Enumeration date
08/23/2005
Last updated
10/02/2012
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