Healthcare Provider Details

I. General information

NPI: 1326248766
Provider Name (Legal Business Name): DAVID K. SMITH M D LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/24/2007
Last Update Date: 06/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1300 HOSPITAL DR SUITE 250
MT PLEASANT SC
29464-3261
US

IV. Provider business mailing address

1300 HOSPITAL DR SUITE 250
MT PLEASANT SC
29464-3261
US

V. Phone/Fax

Practice location:
  • Phone: 843-971-8180
  • Fax: 843-971-9239
Mailing address:
  • Phone: 843-971-8180
  • Fax: 843-971-9239

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number8893
License Number StateSC

VIII. Authorized Official

Name: DAVID K SMITH
Title or Position: OWNER
Credential: M.D.
Phone: 843-971-8180