Individual
ANTOINE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPN
Contact information
Practice address
11100 BILLINGSLEY RD, WALDORF, MD 20602-3400
(240) 754-6100
Mailing address
11100 BILLINGSLEY RD, WALDORF, MD 20602-3400
(240) 754-6100
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP56157
MD
Other
Enumeration date
09/22/2023
Last updated
09/22/2023
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