Provider Demographics
NPI:1144385105
Name:WHITAKERSMITH, VALERIE (OD)
Entity type:Individual
Prefix:
First Name:VALERIE
Middle Name:
Last Name:WHITAKERSMITH
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2421 CLEANLEIGH DR
Mailing Address - Street 2:
Mailing Address - City:PARKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21234-6808
Mailing Address - Country:US
Mailing Address - Phone:410-663-8393
Mailing Address - Fax:410-663-8394
Practice Address - Street 1:2421 CLEANLEIGH DR
Practice Address - Street 2:
Practice Address - City:PARKVILLE
Practice Address - State:MD
Practice Address - Zip Code:21234-6808
Practice Address - Country:US
Practice Address - Phone:410-663-8393
Practice Address - Fax:410-663-8394
Is Sole Proprietor?:No
Enumeration Date:2006-12-27
Last Update Date:2025-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDTA1416152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDU90476Medicare UPIN
MD501M1750Medicare ID - Type UnspecifiedMEDICARE