Individual
STEPHEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
737 S MAIN ST, SOCIETY HILL, SC 29593-8972
(843) 378-4501
Mailing address
PO BOX 1090, HARTSVILLE, SC 29551-1090
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
16284
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080053641
MEDICARE RAILROAD PTAN
SC
05
—
162843
—
SC
Enumeration date
08/15/2006
Last updated
09/01/2017
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