Individual
DERYAN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1000 BLYTHE BLVD, MEB 3, CHARLOTTE, NC 28203
(704) 355-2000
Mailing address
PO BOX 32861, CHARLOTTE, NC 28232-2861
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
2025-01209
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/15/2022
Last updated
06/20/2025
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