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NPI Code Detail

MEDICARE: DR. DAVID L SMITH MD

MEDICARE: DR. DAVID L SMITH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine Physician20668SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1710999750
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DAVID L SMITH MD
Provider Business Mailing Address
First Line : 1316 PENSHELL PL
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-5723
Country : US
Telephone Number : 803-730-5719
Fax Number :
Provider Business Practice Location Address
First Line : 1435 STUART ENGALS BLVD STE 101
Second Line :
City : MOUNT PLEASANT
State : SC
Zip : 29464-7312
Country : US
Telephone Number : 843-800-5686
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/11/2006
Last Update Date : 05/01/2019

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