Individual
MARTIN T SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
3825 ELECTRIC RD STE C, 419 OFFICE CENTER, ROANOKE, VA 24018-4561
(540) 777-1711
(540) 777-1713
Mailing address
3025 MCVITTY FOREST DR, APT. 104, ROANOKE, VA 24018-3564
(540) 777-1711
(540) 777-1713
Taxonomy
Speciality
Code
Description
License number
State
202K00000X
Phlebology Physician
0102050098
VA
207N00000X
Dermatology Physician
Primary
0102050098
VA
207Q00000X
Family Medicine Physician
50098
VA
Other
Enumeration date
10/06/2005
Last updated
02/02/2011
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