Individual
THEODORE RAVENEL SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1690 SKYLYN DR STE 210, SPARTANBURG, SC 29307-1075
(864) 253-8170
(864) 585-7787
Mailing address
PO BOX 743070, ATLANTA, GA 30374-3070
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7493
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
074939
—
SC
01
—
P00386787
MEDICARE RAILROAD PTAN#
GA
01
—
SCE4946067
MEDICARE PIN
SC
01
—
SCE4946084
MEDICARE PIN
SC
01
—
SCE494J577
MEDICARE PIN
SC
Enumeration date
05/19/2006
Last updated
11/05/2020
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us