Individual
DR. TEAETTE L LOUDERBACK-SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
615 W MACPHAIL RD, STE 206, BEL AIR, MD 21014-4305
(410) 638-5101
(410) 638-6854
Mailing address
PO BOX 667, BEL AIR, MD 21014-0667
(410) 939-8789
(410) 939-6335
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
D0061154
MD
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
405553500
—
MD
01
—
64288501
CAREFIRST BC/BS
MD
01
—
E4860013
BLUE CHOICE/FEP
MD
Enumeration date
06/01/2005
Last updated
07/09/2007
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