Individual
ELTON JOHN SMITH
Active
Individual
ELTON JOHN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
0101259244
VA
2084P0800X
Psychiatry Physician
036140146
IL
2084P0800X
Psychiatry Physician
25MA08836800
NJ
2084P0800X
Psychiatry Physician
C1-0008215
DE
2084P0800X
Psychiatry Physician
MD425154
PA
2084P0804X
Child & Adolescent Psychiatry Physician
0101259244
VA
2084P0804X
Child & Adolescent Psychiatry Physician
25MA08836800
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MD425154
LICENSE NUMBER
PA
Enumeration date
05/18/2006
Last updated
10/27/2025
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