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Individual

DR. SERENA SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
115 N SUMTER ST STE 400, SUMTER, SC 29150-4971
(803) 774-7425
Mailing address
PO BOX 402145, ATLANTA, GA 30384-2145
(803) 774-7425

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
41212
CO
207Q00000X
Family Medicine Physician
Primary
51667
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
516677
SC
Enumeration date
09/27/2006
Last updated
02/23/2018
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