Individual
STEPHEN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9330 MEDICAL PLAZA DR, NORTH CHARLESTON, SC 29406-9104
(865) 985-7129
Mailing address
9330 MEDICAL PLAZA DR, NORTH CHARLESTON, SC 29406-9104
(914) 275-7208
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
4761
SC
Other
Enumeration date
01/25/2023
Last updated
06/02/2023
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