MEDICARE: C DANIEL 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
1	208600000X	Surgery Physician	42730	GA

General Provider Information

NPI Number	:	1619990124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	C DANIEL SMITH MD

Provider Business Mailing Address
First Line	:	2795 PEACHTREE RD NE UNIT 1808
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30305-3793
Country	:	US
Telephone Number	:	404-323-4615
Fax Number	:	404-445-8404

Provider Business Practice Location Address
First Line	:	1800 PEACHTREE ST NW STE 444
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30309-2505
Country	:	US
Telephone Number	:	404-445-7787
Fax Number	:	404-445-8404

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

Provider Enumeration Date	:	07/25/2006
Last Update Date	:	08/04/2024

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