Individual
DR. EDDIE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
13609 CARROLLTON BLVD, CARROLLTON, VA 23314-3214
(757) 238-8751
(757) 238-8750
Mailing address
13609 CARROLLTON BLVD, CARROLLTON, VA 23314-3214
(757) 238-8751
(757) 238-8750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101047898
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
-002 -003
TRICARE/CHAMPUS
VA
05
—
005612748
—
VA
05
—
005615577
—
VA
01
—
0574N
NC BC BS
NC
01
—
21017
SENTARA/OPTIMA
VA
01
—
2180466
UHC/MAMSI
VA
01
—
434846
ANTHEM BC/BS HEALTHKEEPER
VA
05
—
790574N
—
NC
01
—
PAR
AETNA
VA
Enumeration date
01/30/2006
Last updated
10/21/2013
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