Individual
CHARLES EDWARD SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1 DOCTORS DRIVE, GREENVILLE, SC 29605
(864) 572-7001
(864) 412-0436
Mailing address
1 DOCTORS DRIVE, GREENVILLE, SC 29605
(864) 572-7001
(864) 412-0436
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
12994
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040010408
RAILROAD MEDICARE
SC
05
—
129943
—
SC
01
—
P00801257
RR MEDICARE
SC
Enumeration date
05/30/2006
Last updated
08/26/2021
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