Individual
JEFFREY SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
273 HUNDRED OAKS PKWY, SUMMERVILLE, SC 29483-8193
(757) 576-2386
Mailing address
273 HUNDRED OAKS PKWY, SUMMERVILLE, SC 29483-8193
(757) 576-2386
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
R038213
SD
367500000X
Certified Registered Nurse Anesthetist
Primary
100943
SC
Other
Enumeration date
11/10/2013
Last updated
10/03/2014
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