Individual
JUSTIN SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNP
Contact information
Practice address
1113 CHURCH ST, CONWAY, SC 29526-4128
(843) 248-6269
Mailing address
2001 MEDICAL PARKWAY, ANNAPOLIS, MD 21401
(443) 481-1366
(443) 481-1370
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R157238
MD
Other
Enumeration date
09/13/2012
Last updated
07/23/2020
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