Individual
DR. IAN BLAKE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-8908
(843) 792-1414
Mailing address
1924 GRACEWOOD DR, CHARLESTON, SC 29414-6679
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
83490
SC
Other
Enumeration date
03/28/2016
Last updated
07/31/2024
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