Individual
MARK DAVID SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
225 BALDWIN AVE, CHARLOTTE, NC 28204-3109
(704) 376-1605
(704) 335-8448
Mailing address
225 BALDWIN AVE, CHARLOTTE, NC 28204-3109
(704) 376-1605
(704) 335-8448
Taxonomy
Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
200301056
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
891346N
—
NC
05
—
N01860
—
SC
01
—
P00074834
RAILROAD MEDICARE
—
Enumeration date
07/14/2005
Last updated
11/11/2024
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