Individual
MR. GLENN R SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
BRODY OUTPATIENT CENTER, 600 MOYE BLVD, GREENVILLE, NC 27858
(252) 744-2207
(252) 744-3794
Mailing address
2100 STANTONSBURG RD, PO BOX 6028, GREENVILLE, NC 27834-2818
(252) 847-4299
(252) 874-8208
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
104089
NC
363AS0400X
Surgical Physician Assistant
Primary
104089
NC
Other
Enumeration date
02/07/2006
Last updated
01/08/2022
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