Individual
DR. TISHA SMITH BOSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3209 COLONIAL DR, COLUMBIA, SC 29203-6930
(803) 434-6113
(803) 758-0106
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6697
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21331
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
213316
—
SC
Enumeration date
03/15/2006
Last updated
03/20/2025
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