Individual
KEVIN ANTHONY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
316 CALHOUN ST, CHARLESTON, SC 29401-1113
(843) 724-2988
(843) 805-6277
Mailing address
PO BOX 2363, INDIANAPOLIS, IN 46206-2363
(843) 724-2988
(843) 805-6277
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
32373
SC
2085R0204X
Vascular & Interventional Radiology Physician
Primary
32373
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1093852642
—
SC
01
—
P00853366
RR MEDICARE
SC
Enumeration date
01/31/2007
Last updated
12/08/2023
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