Provider Demographics
NPI:1104631894
Name:SMITH, MICHELLE M
Entity type:Individual
Prefix:MRS
First Name:MICHELLE
Middle Name:M
Last Name:SMITH
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:MICHELLE
Other - Middle Name:M
Other - Last Name:BELLAMY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:8364 INDIAN HEAD HWY APT C1
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-4547
Mailing Address - Country:US
Mailing Address - Phone:202-705-6931
Mailing Address - Fax:
Practice Address - Street 1:8364 INDIAN HEAD HWY APT C1
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-4547
Practice Address - Country:US
Practice Address - Phone:202-705-6931
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-10
Last Update Date:2025-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant