Individual
MRS. TIFFANY M SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5401 OLD COURT RD, DEPT OF SURGERY, RANDALLSTOWN, MD 21133-5103
(410) 521-2200
Mailing address
5401 OLD COURT RD, ATTN: CREDENTIALING, RANDALLSTOWN, MD 21133-5103
(410) 601-5524
(410) 601-8946
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
C0002851
MD
Other
Enumeration date
04/03/2006
Last updated
07/31/2007
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