Healthcare Provider Details

I. General information

NPI: 1780507426
Provider Name (Legal Business Name): PETER SMYTH EMT-P
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2026
Last Update Date: 07/31/2026
Certification Date: 07/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4425 WILKINSON BLVD
CHARLOTTE NC
28208-5528
US

IV. Provider business mailing address

7384 MILL RUINS AVE SW
CONCORD NC
28025-8537
US

V. Phone/Fax

Practice location:
  • Phone: 845-551-0040
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code146L00000X
TaxonomyParamedic
License NumberP541525
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: