Individual
RYAN WESLEY SMITH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 SURGEONS DR, MYRTLE BEACH, SC 29579
(843) 504-7194
Mailing address
PO BOX 1427, COLUMBIA, SC 29202-1427
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
29753
SC
207L00000X
Anesthesiology Physician
47099
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
777643800
—
MN
Enumeration date
12/29/2005
Last updated
10/06/2019
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