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Individual

ADAM RANDOLPH SMITH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
IDC

Contact information

Practice address
H M SMITH BLVD, CAMP LEJEUNE, NC 28547
(910) 451-5125
Mailing address
205 WINTERGREEN LN, HUBERT, NC 28539-4659
(610) 291-7461

Taxonomy

Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary

Other

Enumeration date
08/04/2020
Last updated
08/05/2025
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