Smith, Michael Dorian

Smith, Michael Dorian is an sole proprietor health care provider with primary practice located at 1241 Mall Dr , Richmond VA 23235-4737. He recently has only one registered license in Behavioral Health & Social Service Providers / Professional, which is considered as his primary health care specialty. Smith, Michael Dorian can be contacted via phone (804) 794-8828.

Contact Information

Primary practice address
1241 Mall Dr Richmond VA 23235-4737
Fax:
Website:

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Professional 101YP2500X 0701000583 Virginia

Profile Details

NPI number 1124073853
LBN Legal business name Smith, Michael Dorian
Credentials PHD
Entity Individual
Sole proprietor 1 Yes
Enumeration date May 23rd, 2006
Last updated Apr 17th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124073853 NPPES
Virginia Other 084256 SENTARA
Virginia Other 082305 SENTARA
Virginia MEDICAID 005407036 SENTARA
Virginia Other 87647 SENTARA

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