Individual
LARRY C SMITH II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
172 MCSWAIN DRIVE, SUITE A, WEST COLUMBIA, SC 29169
(800) 809-1265
(803) 771-7782
Mailing address
4058 SANDWOOD DR, COLUMBIA, SC 29206-2222
(800) 809-1265
(803) 771-7782
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
18842
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
T27824
—
SC
Enumeration date
08/11/2006
Last updated
07/08/2007
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