MEDICARE: SMITH MEDICAL CLINIC, INC.

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
1	261Q00000X	Clinic/Center

General Provider Information

NPI Number	:	1790617496
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SMITH MEDICAL CLINIC, INC.

Provider Business Mailing Address
First Line	:	99 BASKERVILL DRIVE
Second Line	:
City	:	PAWLEYS ISLAND
State	:	SC
Zip	:	29585
Country	:	US
Telephone Number	:	843-237-2672
Fax Number	:	843-237-0369

Provider Business Practice Location Address
First Line	:	1101 HIGHMARKET STREET
Second Line	:
City	:	GEORGETOWN
State	:	SC
Zip	:	29440
Country	:	US
Telephone Number	:	843-237-2672
Fax Number	:

Authorized Official
Title or Position	:	EXECUTIVE DIRECTOR
Name	:	MRS. ANNE M FAUL
Credential	:
Telephone Number	:	843-237-2672

Provider Enumeration Date	:	05/29/2026
Last Update Date	:	05/29/2026

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