Provider Demographics
NPI:1144257791
Name:MATTHEWS-SMITH, VELMALIA DANETTE (MD)
Entity type:Individual
Prefix:DR
First Name:VELMALIA
Middle Name:DANETTE
Last Name:MATTHEWS-SMITH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VELMALIA
Other - Middle Name:DANETTE
Other - Last Name:MATTHEWS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:50 LEROY ST
Mailing Address - Street 2:
Mailing Address - City:POTSDAM
Mailing Address - State:NY
Mailing Address - Zip Code:13676-1786
Mailing Address - Country:US
Mailing Address - Phone:315-265-3300
Mailing Address - Fax:
Practice Address - Street 1:50 LEROY ST
Practice Address - Street 2:
Practice Address - City:POTSDAM
Practice Address - State:NY
Practice Address - Zip Code:13676-1786
Practice Address - Country:US
Practice Address - Phone:315-265-3300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2018-02111207RH0003X, 207RH0003X
MS21842207RH0003X
NY278311207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00844594OtherRR MEDICARE
TN1518005Medicaid
TNP00844594OtherRR MEDICARE