Individual
KEVIN SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
450 W HANES MILL RD, 201, WINSTON SALEM, NC 27105-9141
(336) 747-3479
Mailing address
301 S OAKLAND AVE, STE 6444, STATESVILLE, NC 28687-0837
(336) 747-3479
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
27780134
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
27780134
NON EMERGENCY MEDICAL TRANSPORTATION
NC
Enumeration date
02/10/2016
Last updated
02/10/2016
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