Individual
DR. DANIEL LEE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
314 GOFF MOUNTAIN RD, CROSS LANES, WV 25313-6602
(304) 388-7070
(304) 388-7075
Mailing address
415 MORRIS ST, SUITE 304, CHARLESTON, WV 25301-1842
(304) 388-7783
(304) 388-7788
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
14012
WV
207Q00000X
Family Medicine Physician
14012
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0051744-000
—
WV
01
—
930063433
RAILROAD MEDICARE
—
Enumeration date
04/14/2006
Last updated
12/05/2012
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