Individual
DR. MARK CODY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 MEDICAL CENTER DR., MORGANTOWN, WV 26506
(304) 598-4800
Mailing address
1 MEDICAL CENTER DR., MORGANTOWN, WV 26506
(304) 598-4800
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
24777
WV
2080N0001X
Neonatal-Perinatal Medicine Physician
Primary
24777
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1528032323
—
WV
01
—
WV6539A
MEDICARE PTAN
WV
Enumeration date
06/11/2010
Last updated
09/02/2016
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