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General NPI Number Information
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NPI Number | 1902298664
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Entity Type | Organization
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Legal Business Name | SUSAN C. SMART, LM, CPM
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Dates
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Enumeration Date | 03/04/2015
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Last Update Date | 03/04/2015
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Provider Practice Location Address
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Address Line | 850 FLOYD ROAD EXT
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City | SPARTANBURG
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State | SC
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Zip | 29307-1048
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Country | US
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Telephone | 864-909-0042
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Fax | 864-285-0583
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Provider Business Mailing Address
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Address Line | 950 JOLLEY RD
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City | CHESNEE
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State | SC
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Zip | 29323-9167
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Country | US
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Telephone | 864-909-0042
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Fax | 864-285-0583
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Authorized Official
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Title or Position | LICENSED MIDWIFE, OWNER
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Name | SUSAN C SMART
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Credential | LM, CPM
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Telephone | 864-909-0042
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 176B00000X
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Taxonomy Name | Midwife
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License Number | LMW0006
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License Number State | SC
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