Organization
MARYLAND LUNG ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DENNIS MICHAEL SMITH MD (PRESIDENT OWNER)
(410) 644-5112
Entity
Organization
Contact information
Practice address
3449 WILKENS AVENUE, SUITE 207, BALITIMORE, MD 21229
(410) 644-5112
(410) 644-6517
Mailing address
3449 WILKENS AVENUE, SUITE 207, BALITIMORE, MD 21229
(410) 644-5112
(410) 644-6517
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42116301
BLUE SHIELD
MD
01
—
42116302
BLUE SHIELD
MD
01
—
CA1235
RRMC GROUP
—
01
—
KS48MA
BLUE SHIELD
MD
Enumeration date
08/21/2007
Last updated
08/21/2007
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