MEDICARE: DAVID M. SMITH CH

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
1	111N00000X	Chiropractor	1607	SC

General Provider Information

NPI Number	:	1588766174
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID M. SMITH CH

Provider Business Mailing Address
First Line	:	895 HOUSTON NORTHCUTT BLVD
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-3446
Country	:	US
Telephone Number	:	843-856-0351
Fax Number	:	843-856-0351

Provider Business Practice Location Address
First Line	:	895 HOUSTON NORTHCUTT BLVD
Second Line	:
City	:	MT PLEASANT
State	:	SC
Zip	:	29464-3446
Country	:	US
Telephone Number	:	843-856-0351
Fax Number	:	843-856-0351

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/02/2006
Last Update Date	:	11/06/2007

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