Individual
MR. GREGORY E SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1905 SKIBO ROAD, SUITE 100, FAYETTEVILLE, NC 28314-0261
(910) 864-4357
(910) 221-0099
Mailing address
1905 SKIBO RD, SUITE 100, FAYETTEVILLE, NC 28314-0260
(910) 864-4357
(910) 221-0099
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
103971
NC
363AM0700X
Medical Physician Assistant
Primary
103971
NC
363AM0700X
Medical Physician Assistant
145009
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
103971
LICENSE NUMBER
NC
Enumeration date
01/22/2007
Last updated
03/07/2023
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