Individual
RICHARD THOMAS SMITH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1001 BLYTHE BLVD, SUITE 200D, CHARLOTTE, NC 28203-5866
(704) 373-1813
(704) 342-5871
Mailing address
PO BOX 601067, CHARLOTTE, NC 28260-1067
(704) 373-0212
(704) 342-5871
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
31905
NC
208000000X
Pediatrics Physician
9406
SC
2080P0202X
Pediatric Cardiology Physician
Primary
31905
NC
2080P0202X
Pediatric Cardiology Physician
9406
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1801806377
—
NC
01
—
78028
BCBS
NC
05
—
7978028
—
NC
05
—
N31905
—
SC
Enumeration date
08/08/2006
Last updated
04/25/2014
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