Healthcare Provider Details

I. General information

NPI: 1023115136
Provider Name (Legal Business Name): CAROLINE CLEMENTS SMITH M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 N GRAHAM HOPEDALE RD
BURLINGTON NC
27217-2971
US

IV. Provider business mailing address

2125 OLD FOREST DR
HILLSBOROUGH NC
27278-7341
US

V. Phone/Fax

Practice location:
  • Phone: 336-570-3739
  • Fax: 336-570-1215
Mailing address:
  • Phone: 919-489-3248
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: