Individual
DR. KEVIN SCOTT SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10628 PARK RD, CHARLOTTE, NC 28210-8407
(704) 973-5500
Mailing address
PO BOX 30637, CHARLOTTE, NC 28230-0637
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
9800702
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
21561
STATE MEDICAL BOARD
SC
05
—
8912229
—
NC
01
—
9800702
STATE MEDICAL BOARD
NC
Enumeration date
08/11/2005
Last updated
04/17/2018
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