Individual
DR. CHARLENE MARIE SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
18 FAIRVIEW RD, MEDFORD, NJ 08055-9116
(856) 797-9178
Mailing address
18 FAIRVIEW RD, MEDFORD, NJ 08055-9116
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
25 MA05076000
NJ
2085R0202X
Diagnostic Radiology Physician
MD028614E
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5322502
—
NJ
Enumeration date
09/27/2006
Last updated
12/31/2013
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