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Individual

TERRI S SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5370 RIDGE RD, CHARLOTTE, NC 28269-1106
(704) 316-1491
Mailing address
PO BOX 60447, CHARLOTTE, NC 28260-0447
(704) 384-1056

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
9900346
NC
208000000X
Pediatrics Physician
Primary
9900346
NC
208M00000X
Hospitalist Physician
9900346
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1220O
BCBSNC
NC
05
1295707909
NC
01
232009
MEDICARE OTHER
NC
01
32381
PARTNERS MEDICARE CHOICE
NC
01
5153701
AETNA
NC
05
891220O
NC
05
891220Q
NC
01
90028
MEDCOST
NC
05
NC2528
SC
Enumeration date
02/06/2006
Last updated
10/26/2020
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