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General NPI Number Information
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NPI Number | 1710999750
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Entity Type | Individual
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Provider Name | DAVID L SMITH MD
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Gender | Male
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Dates
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Enumeration Date | 08/11/2006
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Last Update Date | 05/01/2019
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Provider Practice Location Address
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Address Line | 1435 STUART ENGALS BLVD STE 101
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-7312
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Country | US
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Telephone | 843-800-5686
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Fax |
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Provider Business Mailing Address
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Address Line | 1316 PENSHELL PL
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City | MOUNT PLEASANT
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State | SC
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Zip | 29464-5723
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Country | US
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Telephone | 803-730-5719
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 20668
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License Number State | SC
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