Healthcare Provider Details

I. General information

NPI: 1831770106
Provider Name (Legal Business Name): ASHLEY LEIGH SMITH
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2021
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

196 ASHLEY AVE ROOM 202 MAIN HOSPITAL
CHARLESTON SC
29425-8908
US

IV. Provider business mailing address

196 ASHLEY AVE ROOM 202 MAIN HOSPITAL
CHARLESTON SC
29425-8908
US

V. Phone/Fax

Practice location:
  • Phone: 843-792-1912
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207ZP0101X
TaxonomyAnatomic Pathology Physician
License NumberRTL22-1154
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: