E. Smith Surgical Associate Inc

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

MD 066013-L Issued in PA

Legal business name

E. SMITH SURGICAL ASSOCIATE INC

Practice address

261 Meeting House LN
Merion Station, PA 19066-1231

Phone

(610) 771-0290

NPI assigned

Mar 6, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Emmanuel Ademola Smith, M.D.

Title

Owner

Phone

(215) 612-4700

Specialties & licenses 1

Addresses

Other identifiers 5

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1194998400000",
    "number": "1043340441",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3998 RED LION RD",
            "address_2": "SUITE 306",
            "city": "PHILADELPHIA",
            "state": "PA",
            "postal_code": "191141441",
            "telephone_number": "215-612-2652"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "261 MEETING HOUSE LN",
            "city": "MERION STATION",
            "state": "PA",
            "postal_code": "190661231",
            "telephone_number": "610-771-0290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E. SMITH SURGICAL ASSOCIATE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2007-11-14",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "EMMANUEL",
        "authorized_official_middle_name": "ADEMOLA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "215-612-4700",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Surgery",
            "state": "PA",
            "license": "MD 066013-L",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTONE MERCY",
            "identifier": "30027672",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HEALTH PARTNERS",
            "identifier": "36420MD066013L",
            "state": "PW"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HIGH MARK BLUE SHIELD",
            "identifier": "SM1821064",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KEYSTON HP EAST",
            "identifier": "0764657000",
            "state": "PA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "1147631",
            "state": "PA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Surgery Physician in Merion Station, PA
• Providers in Merion Station, PA by specialty
• Surgery Physician in Pennsylvania

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.