Individual
PHILIP SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
8221 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4512
(703) 207-7818
(703) 653-6692
Mailing address
8221 WILLOW OAKS CORPORATE DR, FAIRFAX, VA 22031-4512
(703) 207-7818
(703) 653-6692
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
MD034477
DC
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
0101058192
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0101058192
MEDICAL LICENSE
VA
01
—
MD034477
MEDICAL LICENSE
DC
Enumeration date
07/27/2006
Last updated
12/11/2016
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