Individual
DR. GREGORY C SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1000 W HAMLET AVE, RADIOLOGY DEPT, HAMLET, NC 28345-4522
(843) 669-5162
(843) 667-4573
Mailing address
PO BOX 100523, FLORENCE, SC 29501-0523
(843) 669-5162
(843) 667-4573
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
38691
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1230K
BCBS OF NC
NC
01
—
203824712
STANDARD TAX ID
NC
05
—
5902965
—
NC
01
—
611473300
US DEPT OF LABOR
NC
01
—
944274
DESERET MUTUAL
NC
05
—
G49673
—
SC
Enumeration date
05/01/2006
Last updated
05/15/2012
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