Individual ProviderDiana SmithPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1685 Congress St, Portland, ME 04102(207) 774-5816(207) 828-0361PECOS EnrollmentBased on the most recent information from CMS, provider Diana Smith does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 2:35 PM.Profile DetailsProvider ID1659323137Provider TypeIndividualFull NameSmith, DianaTitleMs.CredentialPA-CGenderFemaleEnumeration Date5/16/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address1685 Congress St, Portland, ME 04102Phone(207) 774-5816Fax(207) 774-3329Mailing LocationMailing Address100 Foden Rd E, Ste 201, South Portland, ME 04106Phone(207) 828-0361Fax(207) 874-1483Provider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicensePA495Maine