1942205398 NPI number — SMITH S. HO, MD, PA

Table of content: (NPI 1942205398)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1942205398 NPI number — SMITH S. HO, MD, PA

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SMITH S. HO, MD, PA
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1942205398
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
12/09/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
7610 CARROLL AVE
Provider Second Line Business Mailing Address:
STE 280
Provider Business Mailing Address City Name:
TAKOMA PARK
Provider Business Mailing Address State Name:
MD
Provider Business Mailing Address Postal Code:
20912-6302
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
301-891-6100
Provider Business Mailing Address Fax Number:
301-891-5836

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
7610 CARROLL AVE
Provider Second Line Business Practice Location Address:
STE 280
Provider Business Practice Location Address City Name:
TAKOMA PARK
Provider Business Practice Location Address State Name:
MD
Provider Business Practice Location Address Postal Code:
20912-6302
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
301-891-6100
Provider Business Practice Location Address Fax Number:
301-891-5836
Provider Enumeration Date:
06/14/2005

Additional Information

Authorized Official

Authorized Official Last Name:
HO
Authorized Official First Name:
SMITH
Authorized Official Middle Name:
S
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
301-891-6100

Provider Taxonomy Codes

  • Taxonomy code: 207R00000X , with the licence number:  D21900 , registered in the state of MD ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 187631700 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 19246-1300 , issued by the state of ( MD ) . This identifiers is of the category "MEDICAID".
  • Identifier: 83167 . This is a "MAMSI" identifier . This identifiers is of the category "OTHER".
  • Identifier: 456144 . This is a "AETNA PPO" identifier . This identifiers is of the category "OTHER".
  • Identifier: 90732 . This is a "AETNA HMO" identifier . This identifiers is of the category "OTHER".




Copyright © 2007-2024 www.npivalidator.com