Provider Demographics
NPI:1457360349
Name:SMITH, KAREN LISA (MD)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:LISA
Last Name:SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 IRVING ST NW # 2A38
Mailing Address - Street 2:
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20010-2976
Mailing Address - Country:US
Mailing Address - Phone:202-877-2829
Mailing Address - Fax:
Practice Address - Street 1:110 IRVING ST NW # 2A38
Practice Address - Street 2:
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20010-2976
Practice Address - Country:US
Practice Address - Phone:202-877-2829
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-07
Last Update Date:2016-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCMD035950207RH0003X, 207RX0202X
MDD58594207RX0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RX0202XAllopathic & Osteopathic PhysiciansInternal MedicineMedical Oncology
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD804101601Medicaid
DC020221YJ9WMedicare PIN
MD298930ZAWAMedicare PIN
DCH61273Medicare UPIN