Healthcare Provider Details

I. General information

NPI: 1871549410
Provider Name (Legal Business Name): ALLISON C SMITH MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ALLISON C TEMPLE MD

II. Dates (important events)

Enumeration Date: 05/25/2006
Last Update Date: 01/30/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

214 LITTLE PALM LOOP
MT PLEASANT SC
29464-6622
US

IV. Provider business mailing address

214 LITTLE PALM LOOP
MT PLEASANT SC
29464-6622
US

V. Phone/Fax

Practice location:
  • Phone: 843-723-3441
  • Fax: 843-805-4040
Mailing address:
  • Phone: 843-723-3441
  • Fax: 843-805-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number20540
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: