Individual
DR. FAYE M. SMITH-CHAKMAKOVA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2170 SOUTH AVE, SOUTH LAKE TAHOE, CA 96150-7026
(530) 541-3420
Mailing address
4TH AND WALNUT, LEBANON, PA 17042-1281
(717) 720-7551
(717) 272-4931
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
C165898
CA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
MD447815
PA
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
R71376
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102944900
—
PA
01
—
P01392613
RAILROAD MEDICARE
PA
01
—
R71376
TRAINING PERMIT
AZ
Enumeration date
02/17/2010
Last updated
03/17/2022
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