Organization
PREMIER CARDIOVASCULAR CARE PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAVID NATHANIEL SMITH (MD)
(704) 609-7334
Entity
Organization
Contact information
Practice address
1600 CHURCHILL DOWNS DR, WAXHAW, NC 28173-6627
(704) 609-7334
(469) 373-3354
Mailing address
1600 CHURCHILL DOWNS DR, WAXHAW, NC 28173-6627
(704) 609-7334
(469) 373-3354
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
103TA0400X
Addiction (Substance Use Disorder) Psychologist
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0850X
Adult Mental Health Clinic/Center
—
—
261QM2500X
Medical Specialty Clinic/Center
Primary
1837
NC
261QP2400X
Prison Health Clinic/Center
—
—
261QV0200X
VA Clinic/Center
—
—
Other
Enumeration date
04/01/2015
Last updated
11/10/2025
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