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Individual

TIMOTHY MONTAGUE-SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
3545 HIGHWAY 17 UNIT 200, MURRELLS INLET, SC 29576-5113
(843) 294-1941
Mailing address
210 VILLAGE CENTER BLVD STE 140, MYRTLE BEACH, SC 29579-6706
(843) 353-3460
(843) 353-3461

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3337
MEDICARE
SC
05
376241
SC
Enumeration date
01/26/2009
Last updated
07/20/2022
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