Individual
GJANJE L SMITH-MATHUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D., MPH
Contact information
Practice address
3000 NEW BERN AVE, RALEIGH, NC 27610-1295
(919) 350-1570
Mailing address
3000 NEW BERN AVE, RALEIGH, NC 27610-1231
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
230008
MA
208800000X
Urology Physician
Primary
2021-03043
NC
208800000X
Urology Physician
MD60140054
WA
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
2021-03043
NC
2088F0040X
Urogynecology and Reconstructive Pelvic Surgery (Urology) Physician
MD60140054
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1831124809
—
WA
Enumeration date
07/11/2006
Last updated
06/30/2022
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