Individual
JENNIFER V. SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-0002
(843) 792-1414
Mailing address
PO BOX 751461, CHARLOTTE, NC 28275-1461
(843) 792-6200
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
240874
MA
207LP3000X
Pediatric Anesthesiology Physician
240874
MA
207LP3000X
Pediatric Anesthesiology Physician
Primary
85581
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
110100806A
—
MA
Enumeration date
06/21/2009
Last updated
01/25/2022
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