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NPI Code Detail

MEDICARE: DR. PAUL D SMITH MD

MEDICARE: DR. PAUL D SMITH MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician15723SC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1154438224
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PAUL D SMITH MD
Provider Business Mailing Address
First Line : PO BOX 896239
Second Line :
City : CHARLOTTE
State : NC
Zip : 28289-6239
Country : US
Telephone Number : 803-791-2722
Fax Number :
Provider Business Practice Location Address
First Line : 2728 SUNSET BLVD STE 104
Second Line :
City : WEST COLUMBIA
State : SC
Zip : 29169-4838
Country : US
Telephone Number : 803-939-2722
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2006
Last Update Date : 07/21/2022

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