Individual
WENDY E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1577 CONGRESS ST, 2ND FLOOR, PORTLAND, ME 04102-2169
(207) 662-1622
(207) 774-1814
Mailing address
301 US ROUTE 1, BUILDING C, SCARBOROUGH, ME 04074-9701
(207) 396-8600
(207) 396-8632
Taxonomy
Speciality
Code
Description
License number
State
207SG0201X
Clinical Genetics (M.D.) Physician
Primary
MD15492
ME
208000000X
Pediatrics Physician
MD15492
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
246790099
—
ME
05
—
30201383
—
NH
Enumeration date
01/10/2007
Last updated
07/25/2012
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