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MARY EBUEKU-SMITH MD NPI 1639514805


NPI Information

NPI: 1639514805
Provider Name: MARY EBUEKU-SMITH, MD
Classification: Pediatrics - 208000000X
Entity Type: Individual

PECOS Registration: Yes

Address:
2001 W 86TH ST
INDIANAPOLIS, IN
ZIP 46260
Phone: (317) 338-6815
Get Directions

Mary Ebueku-smith, MD is a pediatrics in Indianapolis, IN with 11 years of experience. The provider is a pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development. Mary Ebueku-smith, MD NPI is 1639514805. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

Education
Medical School: DREXEL UNIVERSITY COLLEGE OF MEDICINE
Graduation Year:2013

The provider's business location address is:

2001 W 86TH ST
INDIANAPOLIS, IN
ZIP 46260-902
Phone: (317) 338-6815

The NPI 1639514805 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/1/2013 and was last updated on 8/14/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1390200000XStudent in an Organized Health Care Education/Training ProgramNo
2207R00000XInternal MedicineTL4365WYOMINGNo
3208000000XPediatrics11591AWYOMINGNo
4208000000XPediatricsTL4365WYOMINGNo
5208M00000XHospitalistMD213533OREGONNo
6207Q00000XFamily Medicine121121ALASKANo
7207R00000XInternal Medicine60750536WASHINGTONNo
8207R00000XInternal Medicine121121ALASKANo
9207R00000XInternal Medicine11591AWYOMINGNo
10207R00000XInternal MedicineS4942TEXASNo
11208000000XPediatrics01080536AINDIANAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1P02259015OTHERINDIANARR MEDICARE
2300025385MEDICAIDINDIANA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.