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General NPI Number Information
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NPI Number | 1225479520
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Entity Type | Individual
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Provider Name | BRANDON WAYNE SMITH MD
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Gender | Male
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Dates
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Enumeration Date | 07/15/2013
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Last Update Date | 11/13/2024
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Provider Practice Location Address
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Address Line | 1248 HUFFMAN MILL RD STE 101
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City | BURLINGTON
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State | NC
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Zip | 27215-8700
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Country | US
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Telephone | 336-890-3390
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Fax | 336-890-3391
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Provider Business Mailing Address
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Address Line | 300 E WENDOVER AVE
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City | GREENSBORO
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State | NC
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Zip | 27401-1229
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Country | US
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Telephone | 336-663-5220
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 4301102913
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 67097
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License Number State | MN
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Taxonomy #3
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Taxonomy Code | 207T00000X
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Taxonomy Name | Neurological Surgery Physician
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License Number | 202101178
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License Number State | NC
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