Individual
MR. MARK ALAN SMITH I
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
3333 SILAS CREEK PKWY, WINSTON SALEM, NC 27103-3013
(336) 718-8278
Mailing address
5155 LAUREL VIEW DR, WINSTON SALEM, NC 27104-5101
(336) 774-6631
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
096869
NC
367500000X
Certified Registered Nurse Anesthetist
APN 323
SC
Other
Enumeration date
08/22/2005
Last updated
10/28/2020
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