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Individual

DR. KEISHA CHERMISE SMITH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
O.D.

Contact information

Practice address
5709 HIGH POINT RD, SUITE 103, GREENSBORO, NC 27407-7043
(336) 856-8711
(336) 856-0498
Mailing address
5709 HIGH POINT RD, SUITE 103, GREENSBORO, NC 27407-7043
(336) 856-8711
(336) 856-0498

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1966
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
093TT
BCBS PROV #
NC
01
180005599J
RR MEDICARE INDIVIDUAL #
NC
05
5901172
NC
Enumeration date
05/05/2006
Last updated
01/05/2009
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