Individual
DR. CHARLES LEON SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
19374
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
110176601
RAILROAD MCARE
SC
05
—
193748
—
SC
01
—
P00727247
RAILROAD MEDICARE ID-RSFPP
SC
Enumeration date
05/16/2006
Last updated
03/27/2025
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