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Individual

DR. JOHN BALDWIN SMITH III

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
160 CHARLOIS BLVD, WINSTON SALEM, NC 27103-1522
(978) 536-7400
Mailing address
160 CHARLOIS BLVD, WINSTON SALEM, NC 27103-1522
(978) 536-7400

Taxonomy

Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
19652
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0904
MEDICARE
NC
01
1884
PARTNERS MEDICARE CHOICE
NC
01
77799
BLUE CROSS BLUE SHIELD OF NC
NC
05
8977799
NC
Enumeration date
08/18/2006
Last updated
12/07/2011
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