Provider Demographics
NPI:1386759108
Name:SMITH-BANKS, ALBERTINA D (MD)
Entity type:Individual
Prefix:MS
First Name:ALBERTINA
Middle Name:D
Last Name:SMITH-BANKS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1631 MIDTOWN PL
Mailing Address - Street 2:SUITE 107
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27609-1300
Mailing Address - Country:US
Mailing Address - Phone:919-876-1515
Mailing Address - Fax:919-876-5656
Practice Address - Street 1:2721 X RAY DR
Practice Address - Street 2:
Practice Address - City:GASTONIA
Practice Address - State:NC
Practice Address - Zip Code:28054-7491
Practice Address - Country:US
Practice Address - Phone:704-874-2255
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-20
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC9300596208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8977389Medicaid
NCF80670Medicare UPIN