Basic Information
Provider Information
NPI: 1376690818
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: PATTON SMITH
FirstName: ASHA
MiddleName: JAMILA
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 2101 EAST JEFFERSON STREET
Address2: PPQA MEDICARE COMPLIANCE UNIT 6 WEST ATTN THERESA BROOK
City: ROCKVILLE
State: MD
PostalCode: 208524908
CountryCode: US
TelephoneNumber: 3018166660
FaxNumber: 3018166308
Practice Location
Address1: 8550 LEE HIGHWAY
Address2:  
City: FAIRFAX
State: VA
PostalCode: 220311517
CountryCode: US
TelephoneNumber: 7032072818
FaxNumber: 7032072838
Other Information
ProviderEnumerationDate: 01/05/2007
LastUpdateDate: 12/01/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 12/01/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XMD034342DCN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084P0800X0101239454VAY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
2084P0800XD0064123MDN Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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